Is diabetic ketoacidosis at diagnosis of type 1 diabetes associated with secondary episodes of ketoacidosis? A nationwide longitudinal study of Swedish children from 2012 to 2019

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-05-26 DOI:10.1016/j.diabres.2025.112282

Johan H. Wersäll , Peter Adolfsson , Jan Ekelund , Gun Forsander , Karin Åkesson , Ragnar Hanas

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引用次数: 0

Abstract

Aims

The primary aim was to analyze if diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes in children is associated with an increased risk of future DKA episodes. Secondary aims were to assess the effects of parental education level and family income on the risk of recurrent DKA.

Methods

This was a national, retrospective cohort study of children aged 9 months to < 18 years with type 1 diabetes in Sweden from January 1, 2012, to December 31, 2019. DKA was defined as pH < 7.30. Cox proportional hazards models were used to estimate the risk of DKA with adjustments for sex, age, disposable income and parental education level.

Results

A total of 4523 children were included in the study, of whom 909 (20.1 %) had DKA at diagnosis of type 1 diabetes. DKA at diagnosis was not associated with increased risk of another DKA episode during established diabetes (HR 0.77, p = 0.46, 95 %C.I. 0.41–1.51). Low parental education level and low household income were independent predictors of DKA during established diabetes.

Conclusions

DKA at diagnosis of type 1 diabetes does not predict further episodes of DKA. Adverse social determinants of health likely predict long-term increased risk of DKA episodes.

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诊断为1型糖尿病的糖尿病酮症酸中毒是否与继发性酮症酸中毒发作有关？一项针对2012年至2019年瑞典儿童的全国性纵向研究

主要目的是分析儿童1型糖尿病诊断时的糖尿病酮症酸中毒（DKA）是否与未来DKA发作的风险增加有关。次要目的是评估父母教育水平和家庭收入对复发性DKA风险的影响。方法：本研究是一项全国性、回顾性队列研究，研究对象为9个月至11岁的儿童。2012年1月1日至2019年12月31日，瑞典18岁1型糖尿病患者。DKA定义为pH <；7.30. 采用Cox比例风险模型对性别、年龄、可支配收入和父母受教育程度等因素进行校正，估计DKA的风险。结果共纳入4523例儿童，其中909例（20.1%）在诊断为1型糖尿病时发生DKA。诊断时DKA与已确诊糖尿病期间再次发生DKA的风险增加无关（HR 0.77, p = 0.46, 95% C.I.）0.41 - -1.51)。父母教育程度低和家庭收入低是糖尿病患者DKA的独立预测因素。结论1型糖尿病诊断时的DKA不能预测DKA的进一步发作。不利的健康社会决定因素可能预测长期增加的DKA发作风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.