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
Authors' conclusion
In children with T1D, DKA at onset is associated with subclinical cardiac involvement, reflected by elevated cardiac biomarkers, altered diastolic filling parameters, and reduced left ventricular GLS.
Study context
- Population
- Patients <18 years with T1D onset, single centre, January 2024 to March 2025; 60% male, median age 9.8 years [5.2–14.1]
- Participants
- 81 patients
- Exposure
- Diabetic ketoacidosis (DKA) vs non-DKA at T1D onset
- DKAn = 43
- Outcome
- Cardiac biomarkers (troponin I, NT-proBNP) and echocardiographic changes incl. speckle-tracking strain
Methodological detailsobservational, single-centre, consecutive enrolment
- Observational
- Single-centre
- Consecutive enrolment
Main finding
As reported in the abstract
Troponin I · baseline
P < 0.001
Observational data: associations, not effects.
Further findings
NT-proBNP · baseline
P = 0.002
| Outcome | DKA | non-DKA | P value |
|---|---|---|---|
| Left ventricular GLSMost values within the normal range | - 19.2 (range - 20.4 to - 18.1) | - 21.5 (range - 23.0 to - 18.9) | P = 0.029 |
- NT-proBNP: remained elevated at 24 h
Diastolic filling
- Lower E/A ratios and higher peak a'-wave velocities in the DKA group
Multivariable analysis
- Lower bicarbonate (greater DKA severity) independently associated with higher troponin I and NT-proBNP
- Younger age associated with higher NT-proBNP
Original publication
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. Cardiovasc Diabetol. Published 18 September 2026. doi:10.
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