Diabetic Ketoacidosis at Diagnosis in Youth with Type 1 Diabetes Is Associated with a Higher Hemoglobin A1c (A1c) Even with Intensive Insulin Management
Authors' conclusion
Pilot 4T improved A1c outcomes versus the historical cohort, but those with DKA at diagnosis had persistently elevated A1c throughout the study and intensive diabetes management did not mitigate this difference.
Study context
- Population
- Youth with T1D in the first year after diagnosis; median age 9.7 years in both cohortshistorical 271, Pilot 4T 135
- Participants
- 94 / 177 / 67 / 68
- Exposure
- Diabetic ketoacidosis (DKA) vs no DKA at diagnosis, in historical and Pilot 4T cohorts
- Historical DKAn = 94
- Historical without DKAn = 177reference
- 4T DKAn = 67
- 4T without DKAn = 68reference
- Outcome
- HbA1c by DKA status at diagnosis
- Follow-up
- First year postdiagnosis
Methodological detailshistorical control, stratified by DKA status at diagnosis, linear mixed model
- Historical control
- Stratified by DKA status at diagnosis
- Linear mixed model
Main finding
As reported in the abstract
HbA1c, DKA vs without DKA · 6 months
Difference, % (95% CI)P value
Historical DKAvs Historical without DKA
0.5(0.21–0.79)
P < 0.014T DKAvs 4T without DKA
0.38(0.02–0.74)
P = 0.04Observational data: associations, not effects.
Further findings
| Outcome | Difference (%) (95% CI) | P value | |
|---|---|---|---|
| HbA1c, DKA vs without DKA · 12 monthsHistorical DKAvs Historical without DKAHigher with DKA | 0.62 (−0.06 to 1.29) | P = 0.07 | |
| HbA1c, DKA vs without DKA · 12 months4T DKAvs 4T without DKAHigher with DKA | 0.39 (−0.32 to 1.10) | P = 0.29 | |
| −1012Difference, % (linear scale) |
| Outcome | 4T DKA | 4T without DKA |
|---|---|---|
| Highest % TIR (70-180 mg/dL), Pilot 4T | 69% | 75% |
| Timing | weeks 15-20 | weeks 25-30 |
Original publication
Diabetic Ketoacidosis at Diagnosis in Youth with Type 1 Diabetes Is Associated with a Higher Hemoglobin A1c Even with Intensive Insulin Management. Diabetes Technol Ther. Published 1 February 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →