Association of Diabetic Ketoacidosis at Onset, Diabetes Technology Uptake, and Clinical Outcomes After 1 and 2 Years of Follow-up: A Collaborative Analysis of Pediatric Registries Involving 9,269 Children With Type 1 Diabetes From Nine Countries
Authors' conclusion
Severe and nonsevere DKA at type 1 diabetes diagnosis were both associated with persistently higher HbA1c and higher BMI SDS. AID use diminishes the association of DKA at diagnosis and higher HbA1c over time.
Study context
- Population
- Youth (0.5–15.9 years) diagnosed with T1D in 2019–2020, followed for 2 years, from nine countries (Austria, Czechia, Germany, Italy, Luxembourg, New Zealand, Slovenia, Switzerland, U.S. [Colorado]); 54.8% males, mean age 9.0 years
- Participants
- 9,269 participants
- Exposure
- Severe diabetic ketoacidosis (DKA) vs nonsevere DKA vs no DKA at T1D diagnosis
- Outcome
- Adjusted mean HbA1c
- Follow-up
- 1 year
Methodological detailscollaborative analysis of pediatric registries, nine countries
- Collaborative analysis of pediatric registries
- Nine countries
Main finding
As reported in the abstract
Severe DKA vs Nonsevere DKA: P = 0.001 · Severe DKA vs No DKA: P < 0.001
Observational data: associations, not effects.
Further findings
Adjusted mean HbA1c · 2 years — Severe DKA vs Nonsevere DKA · higher with severe DKA
P < 0.001
| Outcome | P value |
|---|---|
| Adjusted mean HbA1c · 2 yearsSevere DKA vs No DKA · higher with severe DKA | P < 0.001 |
DKA at diagnosis (prevalence)
- DKA at diagnosis
- 34.2%
- Severe DKA at diagnosis
- 12.8%
BMI SD score (SDS)
- Higher BMI SDS in both DKA groups vs no DKA
Automated insulin delivery (AID) use and HbA1c · 2 years
- AID use associated with lower HbA1c vs other treatment modalities and moderated differences between DKA groups
- P = 0.072
Original publication
Association of Diabetic Ketoacidosis at Onset, Diabetes Technology Uptake, and Clinical Outcomes After 1 and 2 Years of Follow-up: A Collaborative Analysis of Pediatric Registries Involving 9,269 Children With Type 1 Diabetes From Nine Countries. Diabetes Care. Published 18 February 2025. doi:10.
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