Observational studyBMJ open diabetes research & care2020
Causes of diabetic ketoacidosis among adults with type 1 diabetes mellitus: insulin pump users and non-users.
Observational study in BMJ open diabetes research & care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Efficacy and safety of once-weekly basal insulin therapy in people with type 1 diabetes: A systematic review and meta-analysis.Diabetes, obesity & metabolism · 2026Pooled it
- Once-Weekly Insulin Versus Once-Daily Insulin for Type 1 Diabetes Treatment: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.Endocrinology, diabetes & metabolism · 2025Pooled it
- Pharmacological characteristics of once-weekly insulin icodec in Japanese individuals with type 1 diabetes.Journal of diabetes investigation · 2025Trial
- Recurrent diabetic ketoacidosis burden and precipitant patterns in established type 1 diabetes using continuous subcutaneous insulin infusion versus multiple daily injections: an 11-year retrospective single-center study.BMC endocrine disorders · 2026Article
- Once-Weekly Subcutaneous Insulin Efsitora for the Management of Diabetes Mellitus: A Systematic Review and Meta-Analysis Study.Medeniyet medical journal · 2026Article
- Ketosis Home Management in Pediatric Type 1 Diabetes in Germany: Mismatch Between Subjective Self-Ratings and Objectively Assessed Competence in Preventing Diabetic Ketoacidosis.Children (Basel, Switzerland) · 2026Article
- Autoimmune Type 1 Diabetes in the Era of Disease-Modifying Immune Therapy.Diabetes/metabolism research and reviews · 2025Review
- Genetics of diabetes and its complications: a comprehensive review.Diabetology & metabolic syndrome · 2025Review
- Development of a Real-time Force-based Algorithm for Infusion Failure Detection.Journal of diabetes science and technology · 2024Article
- Therapeutic Insulin Analogue Concentrations at Infusion Sites Enhanced the Pro-Inflammatory Response and Apoptosis in an In Vitro Macrophage-Material Interaction Model.ACS pharmacology & translational science · 2024Article
- The Basis for Weekly Insulin Therapy: Evolving Evidence With Insulin Icodec and Insulin Efsitora Alfa.Endocrine reviews · 2024Review
- Smart Pen Exposes Missed Basal Insulin Injections and Reveals the Impact on Glycemic Control in Adults With Type 1 Diabetes.Journal of diabetes science and technology · 2024Article
- Frequency and Detection of Insulin Infusion Site Failure in the Type 1 Diabetes Exchange Online Community.Diabetes technology & therapeutics · 2023Article
- Diabetic Ketoacidosis in Pregnancy: Clinical Risk Factors, Presentation, and Outcomes.The Journal of clinical endocrinology and metabolism · 2022Article
- Continuous Ketone Monitoring Consensus Report 2021.Journal of diabetes science and technology · 2022Article
- Article
- Effects of Ultra-Long-Acting Insulin Compared to Long-Acting Insulin on Diabetic Ketoacidosis Incidence in Type 1 Diabetes Mellitus Patients.Diabetes, metabolic syndrome and obesity : targets and therapy · 2022Article
- The Evolution of Insulin Administration in Type 1 Diabetes.Journal of diabetes mellitus · 2021Article
- A Novel Approach to Treating Adults With Type 1 Diabetes and Recurrent Diabetic Ketoacidosis: Once-Daily Subcutaneous Basal Insulin With Hybrid Closed-Loop Insulin Pump Therapy.AACE endocrinology and diabetesArticle
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionInsulin pumps are increasingly being used as a method of insulin delivery in patients with type 1 diabetes mellitus (T1DM). Diabetic ketoacidosis (DKA) is a serious complication of T1DM. This study aims to identify the causes of DKA in patients with T1DM on continuous subcutaneous insulin infusion (CSII) and to compare these with patients with T1DM on multiple daily insulin injections (MDIIs). RESEARCH DESIGN AND
methodsThis is a prospective observational study between January and June 2019 at the Cleveland Clinic Fairview Hospital. Demographic, clinical, and biochemical data were obtained from chart review. A questionnaire to explore additional clinical data relating to DKA was administered, with additional items for patients on the insulin pump.
resultsSeventy-four patients were admitted with a diagnosis of DKA between the period of January and June 2019. Of these, 45 met the inclusion criteria and 43 consented. These were divided into two groups: group 1 included patients on MDII and group 2 included CSII. Overall, the most common precipitating factor for developing DKA was insulin non-adherence, seen in 51.2% of the cases. The most common cause of DKA in group 2 was pump/tubing related to 55% of the cases.
conclusionDespite non-adherence being common in both CSII and MDII, a combination of social factors, education and insulin pump malfunction, such as pump/tubing problems, might be playing a pivotal role in DKA etiology in young adults with T1DM, especially in CSII users. Continued education on pump use may reduce the rate of DKA in pump users.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.