Temporal trends in diabetic ketoacidosis at diagnosis of paediatric type 1 diabetes between 2006 and 2016: results from 13 countries in three continents.
Children with diabetes
Complications
Diabetic ketoacidosis
Diagnosis of diabetes
Epidemiology
Type 1 diabetes
Journal
Diabetologia
ISSN: 1432-0428
Titre abrégé: Diabetologia
Pays: Germany
ID NLM: 0006777
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
25
11
2019
accepted:
09
03
2020
pubmed:
10
5
2020
medline:
12
8
2021
entrez:
9
5
2020
Statut:
ppublish
Résumé
The aim of this work was to evaluate geographical variability and trends in the prevalence of diabetic ketoacidosis (DKA), between 2006 and 2016, at the diagnosis of childhood-onset type 1 diabetes in 13 countries over three continents. An international retrospective study on DKA at diagnosis of diabetes was conducted. Data on age, sex, date of diabetes diagnosis, ethnic minority status and presence of DKA at diabetes onset were obtained from Australia, Austria, Czechia, Denmark, Germany, Italy, Luxembourg, New Zealand, Norway, Slovenia, Sweden, USA and the UK (Wales). Mean prevalence was estimated for the entire period, both overall and by country, adjusted for sex and age group. Temporal trends in annual prevalence of DKA were estimated using logistic regression analysis for each country, before and after adjustment for sex, age group and ethnic minority status. During the study period, new-onset type 1 diabetes was diagnosed in 59,000 children (median age [interquartile range], 9.0 years [5.5-11.7]; male sex, 52.9%). The overall adjusted DKA prevalence was 29.9%, with the lowest prevalence in Sweden and Denmark and the highest in Luxembourg and Italy. The adjusted DKA prevalence significantly increased over time in Australia, Germany and the USA while it decreased in Italy. Preschool children, adolescents and children from ethnic minority groups were at highest risk of DKA at diabetes diagnosis in most countries. A significantly higher risk was also found for females in Denmark, Germany and Slovenia. DKA prevalence at type 1 diabetes diagnosis varied considerably across countries, albeit it was generally high and showed a slight increase between 2006 and 2016. Increased awareness of symptoms to prevent delay in diagnosis is warranted, especially in preschool children, adolescents and children from ethnic minority groups.
Identifiants
pubmed: 32382815
doi: 10.1007/s00125-020-05152-1
pii: 10.1007/s00125-020-05152-1
pmc: PMC7351855
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1530-1541Subventions
Organisme : NIDDK NIH HHS
ID : R01 DK127208
Pays : United States
Organisme : NCCDPHP CDC HHS
ID : U18 DP006131
Pays : United States
Organisme : NCCDPHP CDC HHS
ID : U18 DP006138
Pays : United States
Organisme : NCCDPHP CDC HHS
ID : U18 DP006139
Pays : United States
Références
Shrestha SS, Zhang P, Barker L, Imperatore G (2010) Medical expenditures associated with diabetes acute complications in privately insured U.S. youth. Diabetes Care 33(12):2617–2622. https://doi.org/10.2337/dc10-1406
doi: 10.2337/dc10-1406
pubmed: 20843971
pmcid: 2992200
Bui H, To T, Stein R, Fung K, Daneman D (2010) Is diabetic ketoacidosis at disease onset a result of missed diagnosis? J Pediatr 156(3):472–477. https://doi.org/10.1016/j.jpeds.2009.10.001
doi: 10.1016/j.jpeds.2009.10.001
pubmed: 19962155
Duca LM, Reboussin BA, Pihoker C, et al (2019) Diabetic ketoacidosis at diagnosis of type 1 diabetes and glycemic control over time: the SEARCH for diabetes in youth study. Pediatr Diabetes 20(2):172–179. https://doi.org/10.1111/pedi.12809
doi: 10.1111/pedi.12809
pubmed: 30556249
Shalitin S, Fisher S, Yackbovitch-Gavan M, et al (2018) Ketoacidosis at onset of type 1 diabetes is a predictor of long-term glycemic control. Pediatr Diabetes 19(2):320–328. https://doi.org/10.1111/pedi.12546
doi: 10.1111/pedi.12546
pubmed: 28568379
Duca LM, Wang B, Rewers M, Rewers A (2017) Diabetic ketoacidosis at diagnosis of type 1 diabetes predicts poor long-term glycemic control. Diabetes Care 40:1249–1255
doi: 10.2337/dc17-0558
Fredheim S, Johannesen J, Johansen A, et al, Danish Society for Diabetes in Childhood and Adolescence. (2013) Diabetic ketoacidosis at the onset of type 1 diabetes is associated with future HbA
Semenkovich K, Bischoff A, Doty T, et al (2016) Clinical presentation and memory function in youth with type 1 diabetes. Pediatr Diabetes 17(7):492–499. https://doi.org/10.1111/pedi.12314
doi: 10.1111/pedi.12314
pubmed: 26377697
Aye T, Mazaika PK, Mauras N, et al, Diabetes Research in Children Network (DirecNet) Study Group. (2019) Impact of early diabetic ketoacidosis on the developing brain. Diabetes Care 42(3):443–449. https://doi.org/10.2337/dc18-1405
Knip M, Korhonen S, Kulmala P, et al (2010) Prediction of type 1 diabetes in the general population. Diabetes Care 33(6):1206–1212. https://doi.org/10.2337/dc09-1040
doi: 10.2337/dc09-1040
pubmed: 20508230
pmcid: 2875424
Sharp SA, Rich SS, Wood AR, et al (2019) Development and standardization of an improved type 1 diabetes genetic risk score for use in newborn screening and incident diagnosis. Diabetes Care 42(2):200–207. https://doi.org/10.2337/dc18-1785
doi: 10.2337/dc18-1785
pubmed: 30655379
pmcid: 6341291
Barker JM, Goehrig SH, Barriga K, et al, DAISY study. (2004) Clinical characteristics of children diagnosed with type 1 diabetes through intensive screening and follow-up. Diabetes Care 27(6):1399–1404. https://doi.org/10.2337/diacare.27.6.1399
Winkler C, Schober E, Ziegler AG, Holl RW (2012) Markedly reduced rate of diabetic ketoacidosis at onset of type 1 diabetes in relatives screened for islet autoantibodies. Pediatr Diabetes 13(4):308–313. https://doi.org/10.1111/j.1399-5448.2011.00829.x
doi: 10.1111/j.1399-5448.2011.00829.x
pubmed: 22060727
Meehan C, Fout B, Ashcraft J, Schatz DA, Haller MJ (2015) Screening for T1D risk to reduce DKA is not economically viable. Pediatr Diabetes 16(8):565–572. https://doi.org/10.1111/pedi.12313
doi: 10.1111/pedi.12313
pubmed: 26392298
Fritsch M, Schober E, Rami-Merhar B et al (2013) Diabetic ketoacidosis at diagnosis in Austrian children: a population-based analysis, 1989-2011. J Pediatr 163:1484–1488
doi: 10.1016/j.jpeds.2013.06.033
Derraik JGB, Cutfield WS, Maessen SE et al (2018) A brief campaign to prevent diabetic ketoacidosis in children newly diagnosed with type 1 diabetes mellitus: the NO-DKA study. Pediatr Diabetes 19(7):1257–1262. https://doi.org/10.1111/pedi.12722
doi: 10.1111/pedi.12722
pubmed: 30014558
Hekkala AM, Ilonen J, Toppari J, Knip M, Veijola R (2018) Ketoacidosis at diagnosis of type 1 diabetes: effect of prospective studies with newborn genetic screening and follow up of risk children. Pediatr Diabetes 19(2):314–319. https://doi.org/10.1111/pedi.12541
doi: 10.1111/pedi.12541
pubmed: 28544185
Fox LA, Mubasher M, Wolfsdorf JI, et al, T1D Exchange Clinic Network. (2016) T1D exchange clinic network. Characteristics of youth with type 1 diabetes (T1D) with and without a parent with T1D in the T1D exchange clinic registry. J Diabetes 8(6):834–838. https://doi.org/10.1111/1753-0407.12363
Vanelli M, Chiari G, Ghizzoni L, Costi G, Giacalone T, Chiarelli F (1999) Effectiveness of a prevention program for diabetic ketoacidosis in children. An 8-year study in schools and private practices. Diabetes Care 22(1):7–9. https://doi.org/10.2337/diacare.22.1.7
doi: 10.2337/diacare.22.1.7
pubmed: 10333896
King BR, Howard NJ, Verge CF et al (2012) A diabetes awareness campaign prevents diabetic ketoacidosis in children at their initial presentation with type 1 diabetes. Pediatr Diabetes 13(8):647–651. https://doi.org/10.1111/j.1399-5448.2012.00896.x
doi: 10.1111/j.1399-5448.2012.00896.x
pubmed: 22816992
Rewers A, Dong F, Slover RH, Klingensmith GJ, Rewers M (2015) Incidence of diabetic ketoacidosis at diagnosis of type 1 diabetes in Colorado youth, 1998-2012. JAMA 313(15):1570–1572. https://doi.org/10.1001/jama.2015.1414
doi: 10.1001/jama.2015.1414
pubmed: 25898057
Dabelea D, Rewers A, Stafford JM, et al, SEARCH for Diabetes in Youth Study Group. (2014) Trends in the prevalence of ketoacidosis at diabetes diagnosis: the SEARCH for diabetes in youth study. Pediatrics 133(4):e938–e945. https://doi.org/10.1542/peds.2013-2795
Große J, Hornstein H, Manuwald U, Kugler J, Glauche I, Rothe U (2018) Incidence of diabetic ketoacidosis of new-onset type 1 diabetes in children and adolescents in different countries correlates with human development index (HDI): an updated systematic review, meta-analysis, and meta-regression. Horm Metab Res 50(3):209–222. https://doi.org/10.1055/s-0044-102090
doi: 10.1055/s-0044-102090
pubmed: 29523007
Neu A, Hofer S, Karges B, Oeverink R, Rosenbauer J, Holl RW (2009) DPV-initiative and the German BMBF competence network for diabetes mellitus ketoacidosis at diabetes onset is still frequent in children and adolescents: a multicentre analysis of 14,664 patients from 106 institutions. Diabetes Care 32(9):1647–1648. https://doi.org/10.2337/dc09-0553
doi: 10.2337/dc09-0553
pubmed: 19549730
pmcid: 2732146
Usher-Smith JA, Thompson M, Ercole A, Walter FM (2012) Variation between countries in the frequency of diabetic ketoacidosis at first presentation of type 1 diabetes in children: a systematic review. Diabetologia 55(11):2878–2894. https://doi.org/10.1007/s00125-012-2690-2
doi: 10.1007/s00125-012-2690-2
pubmed: 22933123
pmcid: 3464389
Cherubini V, Skrami E, Ferrito L et al (2016) High frequency of diabetic ketoacidosis at diagnosis of type 1 diabetes in Italian children: a nationwide longitudinal study, 2004-2013. Sci Rep 6:38844
doi: 10.1038/srep38844
Maahs DM, Hermann JM, Holman N et al (2015) Rates of diabetic ketoacidosis: international comparison with 49,859 pediatric patients with type 1 diabetes from England, Wales, the US, Austria, and Germany. Diabetes Care 38:1876–1882
doi: 10.2337/dc15-0780
Hofer SE, Schwandt A, Holl RW (2016) Standardized documentation in pediatric diabetology: experience from Austria and Germany. J Diabetes Sci Technol 10(5):1042–1049. https://doi.org/10.1177/1932296816658057
doi: 10.1177/1932296816658057
pubmed: 27381028
pmcid: 5032966
Clapin H, Phelan H, Bruns L Jr et al (2016) Australasian diabetes data network: building a collaborative resource. J Diabetes Sci Technol 10(5):1015–1026. https://doi.org/10.1177/1932296816648983
doi: 10.1177/1932296816648983
pubmed: 27257171
pmcid: 5032958
Skrivarhaug T, Stene LC, Drivvoll AK, Strøm H, Joner G (2014) Incidence of type 1 diabetes in Norway among individuals aged 0-14 years 1989-2012: has the incidence stopped rising? Results from the Norwegian childhood diabetes registry. Diabetologia 57(1):57–62. https://doi.org/10.1007/s00125-013-3090-y
doi: 10.1007/s00125-013-3090-y
pubmed: 24149838
Lansdown AJ, Barton J, Warner J, et al, Brecon Group. (2012) Prevalence of ketoacidosis at diagnosis of childhood onset type 1 diabetes in Wales from 1991 to 2009 and effect of a publicity campaign. Diabet Med 29(12):1506–1509. https://doi.org/10.1111/j.1464-5491.2012.03638.x
Svensson J, Cerqueira C, Kjaersgaard P et al (2016) Danish registry of childhood and adolescent diabetes. Clinical epidemiology 8:679–683. https://doi.org/10.2147/CLEP.S99469
doi: 10.2147/CLEP.S99469
pubmed: 27822115
pmcid: 5094642
Dovc K, Telic SS, Lusa L et al (2014) Improved metabolic control in pediatric patients with type 1 diabetes: a nationwide prospective 12- year time trends analysis. Diabetes Technol Ther 16(1):33–40. https://doi.org/10.1089/dia.2013.0182
doi: 10.1089/dia.2013.0182
pubmed: 24131373
pmcid: 3887404
Šumník Z, Venháčová J, Škvor J, et al, ČENDA Project Group. (2020) Five years of improving diabetes control in Czech children after the establishment of the population-based childhood diabetes register ČENDA. Pediatr Diabetes 21(1):77–87. https://doi.org/10.1111/pedi.12929
United Nations Development Programme (2019) Human development reports. Available from: http://hdr.undp.org/en/data/query . Accessed: 4 May 2019
Benjamini Y, Hochberg Y (1995) Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Statist Soc B 57:289–300
Alonso GT, Coakley A, Pyle L, Manseau K, Thomas S, Rewers A (2020) Diabetic ketoacidosis at diagnosis of type 1 diabetes in Colorado children, 2010-2017. Diabetes Care 43(1):117–121. https://doi.org/10.2337/dc19-0428
doi: 10.2337/dc19-0428
pubmed: 31601639
Benoit SR, Zhang Y, Geiss LS (2018) Trends in diabetic ketoacidosis hospitalizations and in-hospital mortality-United States, 200-2014. Morb Mortal Wkly Rep 67(12):362–365. https://doi.org/10.15585/mmwr.mm6712a3
doi: 10.15585/mmwr.mm6712a3
Usher-Smith JA, Thompson MJ, Sharp SJ, Walter FM (2011) Factors associated with the presence of diabetic ketoacidosis at diagnosis of diabetes in children and young adults: a systematic review. BMJ 343:d4092
doi: 10.1136/bmj.d4092
Lévy-Marchal C, Patterson CC, Green A (2001) Geographical variation of presentation at diagnosis of type I diabetes in children: the EURODIAB study. Diabetologia 44(Suppl 3):B75–B80
doi: 10.1007/PL00002958
Triolo TM, Chase HP, Barker JM, the DPT-1 Study Group (2009) Diabetic subjects diagnosed through the diabetes prevention trial-type 1 (DPT-1) are often asymptomatic with normal A1C at diabetes onset. Diabetes Care 32(5):769–773. https://doi.org/10.2337/dc08-1872
doi: 10.2337/dc08-1872
pubmed: 19407074
pmcid: 2671125
Elding Larsson H, Vehik K, Bell R, et al, TEDDY Study Group., SEARCH Study Group., Swediabkids Study Group., DPV Study Group., Finnish Diabetes Registry Study Group. (2011) Reduced prevalence of diabetic ketoacidosis at diagnosis of type 1 diabetes in young children participating in longitudinal follow-up. Diabetes Care 34(11):2347–2352. https://doi.org/10.2337/dc11-1026
Deylami R, Townson J, Mann M, Gregory JW (2018) Systematic review of publicity interventions to increase awareness amongst healthcare professionals and the public to promote earlier diagnosis of type 1 diabetes in children and young people. Pediatr Diabetes 19(3):566–573. https://doi.org/10.1111/pedi.12565
doi: 10.1111/pedi.12565
pubmed: 28782293
Ziegler AG, Kick K, Bonifacio E, et al, Fr1da Study Group. (2020) Yield of a public health screening of children for islet autoantibodies in Bavaria, Germany. JAMA 323(4):339–351. https://doi.org/10.1001/jama.2019.21565
Patterson CC, Harjutsalo V, Rosenbauer J et al (2019) Trends and cyclical variation in the incidence of childhood type 1 diabetes in 26 European centres in the 25 year period 1989-2013: a multicentre prospective registration study. Diabetologia 62(3):408–417. https://doi.org/10.1007/s00125-018-4763-3
doi: 10.1007/s00125-018-4763-3
pubmed: 30483858
Jefferies C, Cutfield SW, Derraik JG et al (2015) 15-year incidence of diabetic ketoacidosis at onset of type 1 diabetes in children from a regional setting (Auckland, New Zealand). Sci Rep 5:10358
doi: 10.1038/srep10358
Bizzarri C, Benevento D, Ciampalini P et al (2010) Clinical presentation and autoimmune characteristics of very young children at the onset of type 1 diabetes mellitus. J Pediatr Endocrinol Metab 23(11):1151–1157. https://doi.org/10.1515/jpem.2010.180
doi: 10.1515/jpem.2010.180
pubmed: 21284328
Mayer-Davis EJ, Kahkoska AR, Jefferies C et al (2018) ISPAD clinical practice consensus guidelines 2018: definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes 19(Suppl 27):7–19
doi: 10.1111/pedi.12773
von Oettingen J, Wolfsdorf J, Feldman HA, Rhodes ET (2015) Use of serum bicarbonate to substitute for venous pH in new-onset diabetes. Pediatrics 136(2):e371–e377
doi: 10.1542/peds.2015-0156