ArticleDeutsches Arzteblatt international2021
Diabetic Ketoacidosis at Manifestation of Type 1 Diabetes in Childhood and Adolescence—Incidence and Risk Factors.
Article in Deutsches Arzteblatt international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 29 citations in OpenAlex.
- Subclinical cardiac involvement during diabetic ketoacidosis at type 1 diabetes onset in youth: biomarker elevation, altered diastolic filling, and reduced global longitudinal strain: a prospective cohort study.Cardiovascular diabetology · 2026Observational
- An international consensus on screening and monitoring early-stage type 1 diabetes: A roadmap to European implementation.Diabetes, obesity & metabolism · 2026Review
- Is the Current Screening Availability for Early Stages of Type 1 Diabetes in Germany Related to the Population-Based Frequency of Diabetic Ketoacidosis at Clinical Manifestation in Children and Adolescents.Pediatric diabetes · 2026Article
- Optimizing Type 1 Diabetes Screening in People With Family History: A German Perspective.Journal of diabetes science and technology · 2025Review
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- Severe Diabetic Ketoacidosis in Children with Type 1 Diabetes: Ongoing Challenges in Care.Children (Basel, Switzerland) · 2025Review
- Differential expression of plasma proteins and pathway enrichments in pediatric diabetic ketoacidosis.Molecular medicine (Cambridge, Mass.) · 2025Article
- Article
- Article
- [Early Detection Of Type 1 Diabetes By Islet Autoantibody Screening: A Position Paper Of The Fr1daplex Project Leaders And Training Centres, Bvkj Bavaria And Paednetz (Registered) Bavaria].Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) · 2025Article
- Extracellular(Serum) Levels of Matrix Metalloproteinases in Pediatric Type 1 Diabetes Mellitus and Association with Diabetic Ketoacidosis and Cerebral Edema.Diabetes, metabolic syndrome and obesity : targets and therapy · 2025Article
- Metabolomic signature of pediatric diabetic ketoacidosis: key metabolites, pathways, and panels linked to clinical variables.Molecular medicine (Cambridge, Mass.) · 2024Article
- Dietary Influence on Drug Efficacy: A Comprehensive Review of Ketogenic Diet-Pharmacotherapy Interactions.Nutrients · 2024Review
- Frequency, Clinical Characteristics and Predictors of Ketoacidosis at Diagnosis of Type One Diabetes Mellitus in Children and Adolescents from JordanJournal of clinical research in pediatric endocrinology · 2023Article
- Successful medical management of diabetic ketoacidosis at first presentation in a child with type 1 diabetes: A case report.Annals of medicine and surgery (2012) · 2022Article
- Alarming Increase of Ketoacidosis Prevalence at Type 1 Diabetes-Onset in Austria-Results From a Nationwide Registry.Frontiers in pediatrics · 2022Article
- Epidemiological trends in the presentation of diabetic ketoacidosis in children newly diagnosed with type 1 diabetes from 2011 to 2017 in Kuwait.Frontiers in endocrinology · 2022Article
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Authors and funding
9 authors at 9 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiabetic ketoacidosis (DKA) is a potentially life-threatening metabolic disorder that can occur with manifestation of type 1 diabetes mellitus (T1D). The aim of this study was to analyze the incidence of DKA at the time of the diagnosis of T1D in childhood and adolescence, the risk factors, and regional approaches to reduce the incidence of ketoacidosis.
methodsWe investigated the proportion of patients under 18 years of age with DKA (defined as pH <7.3, severe DKA pH <7.1) at the manifestation of T1D in Germany in the period 2000-2019, based on data from the German-Austrian registry of diabetes (Diabetes-Patienten-Verlaufsdokumentation, DPV). The influence of the following factors was evaluated: year of manifestation, age, sex, family history of migration (MiH), and distance from the hospital. Moreover, data from the region with and the region without a pilot screening project from 2015 onwards were compared.
resultsOf the 41 189 patients with manifestation of T1D, 19.8% presented with DKA (n = 8154, slight increase [p <0.001] over the study period) and 6.1% (n = 2513) had severe DKA. Children under 6 years of age had DKA more often than adolescents (12-17 years) (21.7% versus 18.6%, OR 1.22 {95% CI: [1.14; 1.30]}). Girls had a higher rate of DKA than boys (20.5% versus 19.2%, OR 1.10 [1.03; 1.14]), and patients with MiH were more likely to have DKA than those without MiH (21.4% versus 18.2%, OR 1.40 [1.32; 1.48]). In the region with a pilot screening project, the DKA rate stayed the same, at 20.6%, while in the control region the rate was 22.7% with a decreasing tendency.
conclusionThe frequency of DKA at the time of diagnosis of T1D did not decrease between 2000 and 2019 and increased towards the end of the observation period. Children with MiH, children under 6, and girls were at a higher risk of DKA.
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