ArticleDiabetes care2022
Heterogeneity of DKA Incidence and Age-Specific Clinical Characteristics in Children Diagnosed With Type 1 Diabetes in the TEDDY Study.
Article in Diabetes care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Impact of the COVID-19 Pandemic on Children and Adolescents with New-Onset Type 1 Diabetes.Pediatric diabetes · 2023Pooled it
- Islet Autoantibody Patterns Vary by Race and Ethnicity and Area Deprivation Index for Individuals at Risk for Type 1 Diabetes.Diabetes care · 2026Article
- International consensus guidance for general population screening for islet autoantibodies to diagnose early-stage type 1 diabetes: a nominal group technique process.Diabetologia · 2026Article
- Reducing Diabetic Ketoacidosis in Pediatric Type 1 Diabetes: The Impact of Screening Programs and Early Disease-Modifying Treatment.Journal of clinical medicine · 2026Review
- Co-designing a new clinical pathway to support families with children identified as having early-stage type 1 diabetes in Western Australia.Diabetologia · 2026Article
- Development of a Patient-Level Multi-objective Optimisation Model for Screening Strategies for Childhood Type 1 Diabetes.PharmacoEconomics · 2026Article
- Evolution of islet autoantibodies in the Environmental Determinants of Islet Autoimmunity (ENDIA) prospective cohort.Diabetologia · 2026Article
- The Value of HALP Score, SII, and SIRI in Predicting the Need for Intensive Care and Assessing Disease Severity in Pediatric Diabetic Ketoacidosis Cases.Children (Basel, Switzerland) · 2025Article
- Observational
- Health economic considerations of screening for early type 1 diabetes.Diabetes, obesity & metabolism · 2025Review
- Protocol for the development of a core outcome set for type 1 diabetes risk screening.BMJ open · 2025Article
- Looking back at the TEDDY study: lessons and future directions.Nature reviews. Endocrinology · 2025Review
- EDENT1FI Master Protocol for screening of presymptomatic early-stage type 1 diabetes in children and adolescents.BMJ open · 2025Article
- Changes in the Prevalence of Diabetes Ketoacidosis at the Onset of Type 1 Diabetes in Polish Children: A Comparative Analysis Between Two 9-Year Periods-2006-2014 and 2015-2023.Pediatric diabetes · 2025Article
- [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
- Lower Prevalence of Diabetic Ketoacidosis at Diagnosis in Research Participants Monitored for Hyperglycemia.The Journal of clinical endocrinology and metabolism · 2024Article
- Time to reframe the disease staging system for type 1 diabetes.The lancet. Diabetes & endocrinology · 2024Review
- Consensus guidance for monitoring individuals with islet autoantibody-positive pre-stage 3 type 1 diabetes.Diabetologia · 2024Article
- Consensus Guidance for Monitoring Individuals With Islet Autoantibody-Positive Pre-Stage 3 Type 1 Diabetes.Diabetes care · 2024Article
- The Influence of Pubertal Development on Autoantibody Appearance and Progression to Type 1 Diabetes in the TEDDY Study.Journal of the Endocrine Society · 2024Article
Corrections and comments
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Authors and funding
17 authors at 10 institutions in 4 countries.
Funding
Abstract
objectiveThe Environmental Determinants of Diabetes in the Young (TEDDY) study is uniquely capable of investigating age-specific differences associated with type 1 diabetes. Because age is a primary driver of heterogeneity in type 1 diabetes, we sought to characterize by age metabolic derangements prior to diagnosis and clinical features associated with diabetic ketoacidosis (DKA). RESEARCH DESIGN AND
methodsThe 379 TEDDY children who developed type 1 diabetes were grouped by age at onset (0-4, 5-9, and 10-14 years; n = 142, 151, and 86, respectively) with comparisons of autoantibody profiles, HLAs, family history of diabetes, presence of DKA, symptomatology at onset, and adherence to TEDDY protocol. Time-varying analysis compared those with oral glucose tolerance test data with TEDDY children who did not progress to diabetes.
resultsIncreasing fasting glucose (hazard ratio [HR] 1.09 [95% CI 1.04-1.14]; P = 0.0003), stimulated glucose (HR 1.50 [1.42-1.59]; P < 0.0001), fasting insulin (HR 0.89 [0.83-0.95]; P = 0.0009), and glucose-to-insulin ratio (HR 1.29 [1.16-1.43]; P < 0.0001) were associated with risk of progression to type 1 diabetes. Younger children had fewer autoantibodies with more symptoms at diagnosis. Twenty-three children (6.1%) had DKA at onset, only 1 (0.97%) of 103 with and 22 (8.0%) of 276 children without a first-degree relative (FDR) with type 1 diabetes (P = 0.008). Children with DKA were more likely to be nonadherent to study protocol (P = 0.047), with longer duration between their last TEDDY evaluation and diagnosis (median 10.2 vs. 2.0 months without DKA; P < 0.001).
conclusionsDKA at onset in TEDDY is uncommon, especially for FDRs. For those without familial risk, metabolic monitoring continues to provide a primary benefit of reduced DKA but requires regular follow-up. Clinical and laboratory features vary by age at onset, adding to the heterogeneity of type 1 diabetes.
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