Pediatric DKA: Too Often a First-Time Diagnosis for Type 1 Diabetes

Failure to diagnose type 1 diabetes before the onset of diabetic ketoacidosis (DKA) can incur unnecessary morbidity, mortality, and costs. Researchers evaluated the incidence and patient characteristics associated with DKA at the time of a new diagnosis of type 1 diabetes in children <19 years of age who presented to one of seven U.S. pediatric diabetes centers within 90 days of the diabetes diagnosis. Children were included in the analysis if at the time of diagnosis they tested positive for at least one diabetes-associated autoantibody and had pH or HCO₃ values recorded.

Of 805 children (mean age, 9 years; age range, 8 months to 18 years), 277 (34%) presented with DKA, which was moderate to severe (pH <7.2) in 51%. In univariate analysis, …