ArticleDiabetologia2020
Temporal trends in diabetic ketoacidosis at diagnosis of paediatric type 1 diabetes between 2006 and 2016: results from 13 countries in three continents.
Article in Diabetologia, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 96 papers, 4 of them syntheses that pooled it.
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Who cites it
96 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Diabetic foot self-care practices and its predictors among diabetes mellitus patients in Ethiopia: systematic review and meta-analysis.BMJ open · 2025Pooled it
- Magnitude, risk factors and economic impacts of diabetic emergencies in developing countries: A systematic review.PloS one · 2025Pooled it
- Burden of diabetic ketoacidosis and its predictors among diabetic patients in Ethiopia: Systematic review and meta-analysis.PloS one · 2025Pooled it
- Incidence of Diabetic Ketoacidosis Among Pediatrics With Type 1 Diabetes Prior to and During COVID-19 Pandemic: A Meta-Analysis of Observational Studies.Frontiers in endocrinology · 2022Pooled it
- Increasing Trends in Hospitalisation With Diabetic Ketoacidosis at Type 1 Diabetes Diagnosis Among Children and Youth in the United States and England, 2002-2020.Diabetes, obesity & metabolism · 2026Article
- Article
- International consensus guidance for general population screening for islet autoantibodies to diagnose early-stage type 1 diabetes: a nominal group technique process.Diabetologia · 2026Article
- Clinical Predictors of Time to Hospital Discharge in Children With New-Onset Diabetic Ketoacidosis in Zambia: A Retrospective Cohort Study.Endocrinology, diabetes & metabolism · 2026Article
- Article
- Reducing Diabetic Ketoacidosis in Pediatric Type 1 Diabetes: The Impact of Screening Programs and Early Disease-Modifying Treatment.Journal of clinical medicine · 2026Review
- Screening and Monitoring for Presymptomatic Type 1 Diabetes: A Time for Action.Hormone research in paediatrics · 2026Review
- Predicting health and disease: a conceptual framework for AI in preventive and precision medicine.BMJ health & care informatics · 2026Review
- Life-threatening acute complications persist among individuals with type 1 diabetes in Japan: A nationwide registry-based cross-sectional study.Journal of diabetes investigation · 2026Article
- High-fidelity simulation-based validation of applicability of the new Italian society for pediatric endocrinology and diabetes (ISPED) recommendations for pediatric diabetic ketoacidosis management.Acta diabetologica · 2026Article
- Continuous glucose monitoring as a tool in early-stage type 1 diabetes.Diabetologia · 2026Review
- An international consensus on screening and monitoring early-stage type 1 diabetes: A roadmap to European implementation.Diabetes, obesity & metabolism · 2026Review
- Hospitalization profile among pediatric populations with type 1 diabetes mellitus in Australia: An ecological study.Medicine · 2026Article
- Protection through early knowledge: clinical onset of type 1 diabetes in children and adolescents with and without early T1D detection programmes.BMC pediatrics · 2026Article
- Screening for diabetes mellitus type 1 in the pediatric general population: an ethical analysis.European journal of pediatrics · 2026Review
- Ketoacidosis at childhood type 1 diabetes onset negatively affects residual beta-cell functions during the first year after diagnosis.Scientific reports · 2026Article
36 more citing papers are in PubMed but not listed here.
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24 authors.
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Abstract
aims/hypothesisThe aim of this work was to evaluate geographical variability and trends in the prevalence of diabetic ketoacidosis (DKA), between 2006 and 2016, at the diagnosis of childhood-onset type 1 diabetes in 13 countries over three continents.
methodsAn international retrospective study on DKA at diagnosis of diabetes was conducted. Data on age, sex, date of diabetes diagnosis, ethnic minority status and presence of DKA at diabetes onset were obtained from Australia, Austria, Czechia, Denmark, Germany, Italy, Luxembourg, New Zealand, Norway, Slovenia, Sweden, USA and the UK (Wales). Mean prevalence was estimated for the entire period, both overall and by country, adjusted for sex and age group. Temporal trends in annual prevalence of DKA were estimated using logistic regression analysis for each country, before and after adjustment for sex, age group and ethnic minority status.
resultsDuring the study period, new-onset type 1 diabetes was diagnosed in 59,000 children (median age [interquartile range], 9.0 years [5.5-11.7]; male sex, 52.9%). The overall adjusted DKA prevalence was 29.9%, with the lowest prevalence in Sweden and Denmark and the highest in Luxembourg and Italy. The adjusted DKA prevalence significantly increased over time in Australia, Germany and the USA while it decreased in Italy. Preschool children, adolescents and children from ethnic minority groups were at highest risk of DKA at diabetes diagnosis in most countries. A significantly higher risk was also found for females in Denmark, Germany and Slovenia. CONCLUSIONS/
interpretationDKA prevalence at type 1 diabetes diagnosis varied considerably across countries, albeit it was generally high and showed a slight increase between 2006 and 2016. Increased awareness of symptoms to prevent delay in diagnosis is warranted, especially in preschool children, adolescents and children from ethnic minority groups.
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