ArticleCMAJ open
Increasing prevalence of diabetic ketoacidosis at diabetes diagnosis among children in Quebec: a population-based retrospective cohort study.
Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Gestational diabetes and parental type 2 diabetes as risk indicators for type 1 diabetes in offspring: a systematic review and meta-analysis.EClinicalMedicine · 2025Article
- A Machine Learning Model for Risk Stratification of Postdiagnosis Diabetic Ketoacidosis Hospitalization in Pediatric Type 1 Diabetes: Retrospective Study.JMIR diabetes · 2024Article
- Estimated Cost-effectiveness of Subcutaneous Insulin Aspart in the Management of Mild Diabetic Ketoacidosis Among Children.JAMA network open · 2022Article
- Increase in Prevalence of Diabetic Ketoacidosis at Diagnosis Among Youth With Type 1 Diabetes: The SEARCH for Diabetes in Youth Study.Diabetes care · 2021Article
- Diabetic ketoacidosis at presentation of type 1 diabetes in children in Canada during the COVID-19 pandemic.Paediatrics & child health · 2021Article
- Diabetic ketoacidosis at type 1 diabetes diagnosis in children during the COVID-19 pandemic.Pediatric diabetes · 2021Article
- Fluid management in children with diabetic ketoacidosis.Canadian family physician Medecin de famille canadien · 2020Article
- The changing face of paediatric diabetes.Diabetologia · 2020Review
- Management of Diabetic Ketoacidosis in Adults: A Narrative Review.Saudi journal of medicine & medical sciencesReview
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Authors and funding
6 authors.
Funding
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Abstract
backgroundDiabetic ketoacidosis at type 1 diabetes diagnosis is a preventable life-threatening complication. Canadian data on the temporal trends of the prevalence of diabetic ketoacidosis at the onset of type 1 diabetes in children are unknown. We aimed to determine the temporal changes in diabetic ketoacidosis prevalence at diabetes diagnosis in Quebec.
methodsWe conducted a population-based cohort study of children (aged 1-17 yr) living in Quebec who were diagnosed with diabetes between 2001 and 2014, using multiple health administrative linked databases available at the Institut national de santé publique du Québec through the Quebec Integrated Chronic Surveillance System. We used multivariate Poisson regression analysis with robust error variance to determine trends in the prevalence of diabetic ketoacidosis.
resultsWe found that 25.6% (1471/5741) of children presented with diabetic ketoacidosis at diabetes diagnosis. The incidence of diabetes was stable at 30 cases per 100 000 children per year during the study period. The age- and sex-standardized rates of diabetic ketoacidosis increased from 22% (95% confidence interval [CI] 17%-26%) in 2001 to 30% (95% CI 24%-36%) in 2014. The relative increase of diabetic ketoacidosis prevalence at diabetes diagnosis over the study period was 2.0% per year (rate ratio 1.02; 95% CI 1.01-1.03).
interpretationDespite a stable incidence of type 1 diabetes, we found that the prevalence of diabetic ketoacidosis at diabetes onset increased between 2001 and 2014. Our findings are concerning and demonstrate a need to continue to campaign to recognize type 1 diabetes before diabetic ketoacidosis supervenes.
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