Ketoacidosis at diabetes onset is still frequent in children and adolescents: a multicentre analysis of 14,664 patients from 106 institutions

  1. Andreas Neu, MD (andreas.neu{at},
  2. Sabine E. Hofer, MD2,
  3. Beate Karges, MD3,
  4. Rudolf Oeverink, MD4,
  5. Joachim Rosenbauer, MD5,
  6. Reinhard W. Holl, MD6 and
  7. for the DPV initiative and the German BMBF Competency Network for Diabetes Mellitus
  1. 1 University Children's Hospital, Tübingen, Germany
  2. 2 Dept. of Pediatrics, Medical University of Innsbruck, Austria
  3. 3 RWTH Aachen University, Dept. of Endocrinology and Pediatrics, Germany
  4. 4 Endocrine Consulting Practitioner, Oldenburg, Germany
  5. 5 Deutsches Diabetes Zentrum, Düsseldorf University, Germany
  6. 6 University of Ulm, Dept. of Epidemiology, Ulm, Germany


    Objective: We aimed at analyzing the frequency, clinical characteristics, and trends associated with the occurrence of ketoacidosis at the onset of type 1 diabetes mellitus on the basis of long-term follow-up data.

    Research design and methods: A total of 106 paediatric diabetes centres in Germany and Austria participated in this study. Data of 14,664 patients with type 1 diabetes collected between 1995 and 2007 were suitable for evaluation. Ketoacidosis (DKA) was defined and classified according to the ISPAD consensus guidelines.

    Results: DKA was observed in 21.1% of patients. The frequency of DKA, including the severe form, remained unchanged throughout the 13 years' observation period. The frequency of DKA was particularly striking among children < 5 years of age (26.5%).

    Conclusions: Ketoacidosis occurring at diabetes onset continues to be a difficult problem. Our data show no significant change in the frequency and magnitude of DKA over the last 13 years.


      • Received March 20, 2009.
      • Accepted June 16, 2009.

    This Article

    1. Diabetes Care
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