The DOI matches its Crossref record; 37 of the 37 references it cites were found in a registry or an index.
Increase in Prevalence of Diabetic Ketoacidosis at Diagnosis Among Youth With Type 1 Diabetes: The SEARCH for Diabetes in Youth Study
Open accessAbstract
OBJECTIVE We previously reported a high (˜30%) but stable prevalence of diabetic ketoacidosis (DKA) at youth-onset diagnosis of type 1 diabetes (2002 and 2010). Given the changing demographics of youth-onset type 1 diabetes, we sought to evaluate temporal trends in the prevalence of DKA at diagnosis of type 1 diabetes from 2010 to 2016 among youth <20 years of age and evaluate whether any change observed was associated with changes in sociodemographic distribution of those recently diagnosed. RESEARCH DESIGN AND METHODS We calculated prevalence of DKA within 1 month of type 1 diabetes diagnosis by year and evaluated trends over time (2010–2016) (n = 7,612 incident diabetes cases; mean [SD] age 10.1 [4.5] at diagnosis). To assess whether trends observed were attributable to the changing distribution of sociodemographic factors among youth with incident type 1 diabetes, we estimated an adjusted relative risk (RR) of DKA in relation to calendar year, adjusting for age, sex, race/ethnicity, income, education, health insurance status, language, season of diagnosis, and SEARCH for Diabetes in Youth Study site. RESULTS DKA prevalence increased from 35.3% (95% CI 32.2, 38.4) in 2010 to 40.6% (95% CI 37.8, 43.4) in 2016 (Ptrend = 0.01). Adjustment for sociodemographic factors did not substantively change the observed trends. We observed a 2% annual increase in prevalence of DKA at or near diagnosis of type 1 diabetes (crude RR 1.02 [95% CI 1.01, 1.04] and adjusted RR 1.02 [95% CI 1.01, 1.04]; P = 0.01 for both). CONCLUSIONS Prevalence of DKA at or near type 1 diabetes diagnosis has increased from 2010 to 2016, following the high but stable prevalence observed from 2002 to 2010. This increase does not seem to be attributable to the changes in distribution of sociodemographic factors over time.
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“Children with type 1 diabetes often present with the hallmark symptoms of polyuria/polydipsia, and approximately half present with diabetic ketoacidosis (DKA) (30 -32).”
From 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2024 (2024) · cites this paper as [32]
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“Children and adolescents often present with DKA as the fi rst manifestation of the disease, and rates in the U.S. have increased dramatically over the past 20 years (30 -32).”
From 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2024 (2024) · cites this paper as [32]
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“People with type 1 diabetes often present with acute symptoms of diabetes and markedly elevated blood glucose levels, and 25 -50% are diagnosed with life-threatening DKA (30 -32).”
From 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2024 (2024) · cites this paper as [32]
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Citations
Cites
Taylor, C. A., Bell, J. M., Breiding, M. J., & Xu, L. (2017) · MMWR Surveillance Summaries · doi:10.15585/mmwr.ss6609a1 · Cited by 2,331
Incidence trends of type 1 and type 2 diabetes among youths, 2002–2012
Mayer-Davis, E. J., Lawrence, J. M., Dabelea, D., Divers, J., Isom, S., Dolan, L., Imperatore, G., Linder, B., Marcovina, S., Pettitt, D. J., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1610187 · Cited by 1,476
The SEARCH for Diabetes in Youth Study: Rationale, Findings, and Future Directions
Hamman, R. F., Bell, R. A., Dabelea, D., D’Agostino, R. B., Dolan, L. M., Imperatore, G., Lawrence, J. M., Linder, B. L., Marcovina, S. M., Mayer‐Davis, E. J., et al. (2014) · Diabetes Care · doi:10.2337/dc14-0574 · Cited by 637
Sommers, B. D., Blendon, R. J., Orav, E. J., & Epstein, A. M. (2016) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2016.4419 · Cited by 528
Predictors of Acute Complications in Children With Type 1 Diabetes
Rewers, A. (2002) · JAMA · doi:10.1001/jama.287.19.2511 · Cited by 493
Dhatariya, K. K., Glaser, N. S., Codner, E., & Umpierrez, G. E. (2020) · Nature Reviews Disease Primers · doi:10.1038/s41572-020-0165-1 · Cited by 461
Dabelea, D., Rewers, A., Stafford, J. M., Standiford, D. A., Lawrence, J. M., Saydah, S., Imperatore, G., D’Agostino, R. B., Mayer-Davis, E. J., & Pihoker, C. (2014) · Pediatrics · doi:10.1542/peds.2013-2795 · Cited by 417
Diabetic ketoacidosis and hyperglycemic hyperosmolar state
Wolfsdorf, J. I., Allgrove, J., Craig, M. E., Edge, J., Glaser, N. S., Jain, V., Lee, W. W., Mungai, L., Rosenbloom, A. L., Sperling, M. A., et al. (2014) · Pediatric Diabetes · doi:10.1111/pedi.12165 · Cited by 369
Benoit, S. R., Zhang, Y., Geiss, L. S., Gregg, E. W., & Albright, A. L. (2018) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6712a3 · Cited by 351
Yield of a public health screening of children for islet autoantibodies in Bavaria, Germany
Ziegler, A.-G., Kick, K., Bonifacio, E., Haupt, F., Hippich, M., Dunstheimer, D., Lang, M., Laub, O., Warncke, K., Lange, K., et al. (2020) · JAMA · doi:10.1001/jama.2019.21565 · Cited by 312
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ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Gaglia, J. L., Hilliard, M. E., Isaacs, D. M., et al. (2022) · Diabetes Care · doi:10.2337/dc23-s002 · Cited by 2,841
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2. Diagnosis and classification of diabetes: standards of care in diabetes-2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Ebekozien, O., Echouffo-Tcheugui, J. B., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s002 · Cited by 1,393
2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2026
American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., et al. (2026) · Diabetes Care · doi:10.2337/dc26-s002 · Cited by 473
Metadata
- Authors
- Jensen, E. T., Stafford, J. M., Saydah, S., D’Agostino, R. B., Dolan, L. M., Lawrence, J. M., Marcovina, S., Mayer-Davis, E. J., Pihoker, C., Rewers, A., & Dabelea, D.
- Affiliations
- Wake Forest University Health Sciences (US)
- Centers for Disease Control and Prevention (US)
- University of Cincinnati (US)
- Kaiser Permanente (US)
- University of Washington (US)
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC
- University of Colorado Denver (US)
- Colorado School of Public Health (US)
- Corresponding author
- Jensen, Elizabeth T.
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2021-07-01
- Volume
- 44
- Issue
- 7
- Pages
- 1573-1578
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC8323183
- OpenAlex
- W3170862402
- Cited by
- 137
- References
- 37
- Citations by year
- 2026: 26 · 2025: 35 · 2024: 25 · 2023: 18 · 2022: 18 · 2021: 15
- FWCI
- 14.22
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Kaiser Permanente (UL1 TR000077, 200-2010-35171, U01 DP000244, U18DP002710-01, U01 DP000248, UL1 TR00423, U18DP002708, 1U18DP002709, U01 DP000246, U48/CCU419249, UL1 TR000062, U18DP006134, DP000254, U18DP006136, U01 DP000247, U48/CCU819241-3, UL1 TR000154, P30 DK57516, U48/CCU919219, U18DP002714, U18DP006139, U18DP006138, 1UC4DK108173, U18DP006133, UL1 TR001425, U58/CCU019235-4, U18DP002710, U18DP000247-06A1, U01 DP000250, U01 DP000254)
- Medical University of South Carolina (TR001450, UL1TR001450, UL1TR000062)
- Wake Forest University (U18DP002714, U18DP002710, U58/CCU019235-4, 200-2010-35171, UL1 TR000077, U18DP006138, U18DP000247-06A1, U18DP006139, U18DP002708, UL1 TR000154, UL1 TR001425, U18DP002710-01, U48/CCU819241-3, U01 DP000247, U18DP006133, UL1 TR00423, 1U18DP002709, P30 DK57516, U48/CCU419249, UL1 TR000062, U18DP006131, U01 DP000246, U18DP006136, DP000254, U48/CCU919219, 1UC4DK108173, U01 DP000244, U01 DP000248, U18DP006134, U01 DP000250, U01 DP000254)
- University of Washington (UL1 TR00423)
- University of Cincinnati (UL1 TR000077, UL1 TR001425)
- University of South Carolina (UL1 TR000062)
- Seattle Children's Research Institute
- Ohio Department of Health (U48/CCU919219, UL1 TR001425, U18DP006136, U01 DP000246, U58/CCU019235-4, U48/CCU419249, U18DP006134, U18DP000247-06A1, UL1 TR000062, U18DP002708, U18DP002710-01, 200-2010-35171, U18DP006139, UL1 TR000154, 1U18DP002709, UL1 TR000077, 1UC4DK108173, UL1 TR00423, P30 DK57516, U01 DP000254, U01 DP000248, U18DP006138, U01 DP000250, U01 DP000247, U18DP006133, U18DP002714, U01 DP000244)
- National Institutes of Health (UL1TR000154, U18DP002708, U18DP006138, U48/CCU419249, UL1TR000423, U18DP006136, UL1TR000062, U58/CCU019235-4, U48/CCU919219, U18DP006139, U18DP006133, U01 DP000250, UL1TR001425, U01 DP000247, U18DP002710, U18DP002714, U01 DP000246, U01 DP000244, 1U18DP002709, U48/CCU819241-3, U18DP000247-06A1, 200-2010-35171, DP000254, U18DP002710-01, U01 DP000254, U01 DP000248, UL1TR001450, U18DP006134, UL1TR000077, TR000077, TR000062, DK57516, TR001425, TR000154)
- Centers for Disease Control and Prevention (UL1 TR00423, U18DP002714, 200-2010-35 171, U01DP000244, U01DP000250, U18DP000247‐06A1, U18DP006138, U18DP006134, U18DP002710, U48/CCU419249, U18DP006136, U58/CCU019235-4, UL1 TR000062, UL1 TR001425, U18DP006139, U18DP002708, U01DP000247, U01DP000248, U18DP002710‐01, DP000254, P30 DK57516, U01DP000254, U01DP000246, UL1 TR000154, U48/CCU919219, U18DP006133, UL1 TR000077, U48/CCU819241‐3, 1UC4DK108173, 1U18DP002709)
- University of North Carolina at Chapel Hill (U01 DP000248, U18DP002714, UL1 TR001425, DP000254, U01 DP000250, U18DP000247-06A1, UL1 TR000077, U48/CCU419249, 200-2010-35171, U01 DP000247, U18DP002710, U18DP006133, U18DP006136, U18DP006134, U48/CCU919219, UL1 TR000062, U48/CCU819241‐3, U58/CCU019235-4, 1U18DP002709, U01 DP000254, U01 DP000246, U01 DP000244, 1UC4DK108173, P30 DK57516, U18DP006139, U18DP002708, UL1 TR00423, U18DP006138, UL1 TR000154, U18DP002710-01)
- University of Colorado Denver (U18DP002714, U01 DP000244, 200-2010-35171, U48/CCU819241-3, U18DP006134, U01 DP000254, U18DP006136, U18DP006133, DP000254, UL1 TR000077, 1U18DP002709, U18DP000247-06A1, U01 DP000246, U01 DP000248, U18DP002708, 1UC4DK108173, U18DP006139, U01 DP000250, UL1 TR000154, U48/CCU419249, U18DP006138, P30 DK57516, U01 DP000247, UL1 TR00423, U18DP002710, UL1 TR000062, U48/CCU919219, U18DP002710-01, U58/CCU019235-4, UL1 TR001425)
- National Institute of Diabetes and Digestive and Kidney Diseases (U18DP006133, 200-2010-35171, U01 DP000250, U18-DP-002714, U01-DP-000247, P30DK057516, 1U18-DP-002709, U01 DP000248, U01 DP000254, U48/CCU919219, U18DP006139, U18DP006131, U48/CCU419249, U01 DP000254, and U18DP002708, UC4DK108173, U18-DP-002708, U48/CCU919219, U01 DP000250, and 200-2010-35171, U01 DP000244, U58/CCU019235-4, U18-DP-000247-06A1, R01DK127208, U48/CCU819241-3, U18DP002710-01, U18DP006136, U18DP006138, U18DP006134, U58/CCU019235-4, U01 DP000244, and U18DP002710-01, U48/CCU819241-3, U01 DP000247, and U18DP000247-06A1, U01-DP-000246, U18DP002710, DP000254, U48/CCU419249)
- National Center for Chronic Disease Prevention and Health Promotion (U01 DP-000247, U18 DP-002709, U18 DP006134, U18-DP-002708, U01-DP000246, U01-DP-000250, U01-DP-000254, U18 DP002714, U18 DP006139, U01 DP000248, U18 DP006138, U18 DP006136, U18 DP006131, U18 DP006133, U01DP000244, U18 DP002710)
- National Center for Advancing Translational Sciences (TR001450, U18DP000247-06A1, U01 DP000244, U58/CCU019235-4, U01 DP000248, U18DP002708, U18DP002714, U48/CCU919219, U01 DP000246, 200-2010-35171, U01 DP000254, U48/CCU419249, U01 DP000250, U18DP006134, U18DP006136, U18DP002710-01, 1U18DP002709, U18DP006138, UL1 TR000062 and UL1 TR001450, U01 DP000247, U18DP006139, U18DP006133)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- diabetic ketoacidosis, type 1 diabetes, youth-onset diabetes, prevalence trends, SEARCH for Diabetes in Youth, sociodemographic factors, diabetes diagnosis, temporal trends
- MeSH terms
- Adolescent, Child, Diabetes Mellitus, Type 1, Ethnicity, Humans, Prevalence, Diabetic Ketoacidosis
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