Reduced Prevalence of Diabetes Ketoacidosis at Diagnosis of Type 1 Diabetes in Young Children Participating in Longitudinal Follow-Up

  1. Finnish Diabetes Registry Study Group*
  1. 1Department of Pediatrics, Skåne University Hospital, Lund University, Malmö, Sweden
  2. 2Pediatric Epidemiology Center, University of South Florida, Tampa, Florida
  3. 3Department of Epidemiology, Wake Forrest University, Winston-Salem, North Carolina
  4. 4Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado
  5. 5Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio
  6. 6Department of Pediatrics, University of Washington, Seattle, Washington
  7. 7Children’s Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
  8. 8Folkhälsan Research Center, Helsinki, Finland
  9. 9Department of Pediatrics, Tampere University Hospital, Tampere, Finland
  10. 10Department of Pediatrics, University of Oulu, Oulu, Finland
  11. 11Department of Pediatrics, The Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden
  12. 12Department of Health and Environment, Linköping University, Linköping, Sweden
  13. 13Institute of Epidemiology, University of Ulm, Ulm, Germany
  14. 14Department of Pediatrics, University of Florida, Gainesville, Florida
  1. Corresponding author: Helena Elding Larsson, helena.larsson{at}
  1. H.E.L. and M.J.H. contributed equally to this work.


OBJECTIVE Young children have an unacceptably high prevalence of diabetic ketoacidosis (DKA) at the clinical diagnosis of type 1 diabetes. The aim of this study was to determine whether knowledge of genetic risk and close follow-up for development of islet autoantibodies through participation in The Environmental Determinants of Diabetes in the Young (TEDDY) study results in lower prevalence of DKA at diabetes onset in children aged <2 and <5 years compared with population-based incidence studies and registries.

RESEARCH DESIGN AND METHODS Symptoms and laboratory data collected on TEDDY participants diagnosed with type 1 diabetes between 2004 and 2010 were compared with data collected during the similar periods from studies and registries in all TEDDY-participating countries (U.S., SEARCH for Diabetes in Youth Study; Sweden, Swediabkids; Finland, Finnish Pediatric Diabetes Register; and Germany, Diabetes Patienten Verlaufsdokumenation [DPV] Register).

RESULTS A total of 40 children younger than age 2 years and 79 children younger than age 5 years were diagnosed with type 1 diabetes in TEDDY as of December 2010. In children <2 years of age at onset, DKA prevalence in TEDDY participants was significantly lower than in all comparative registries (German DPV Register, P < 0.0001; Swediabkids, P = 0.02; SEARCH, P < 0.0001; Finnish Register, P < 0.0001). The prevalence of DKA in TEDDY children diagnosed at <5 years of age (13.1%) was significantly lower compared with SEARCH (36.4%) (P < 0.0001) and the German DPV Register (32.2%) (P < 0.0001) but not compared with Swediabkids or the Finnish Register.

CONCLUSIONS Participation in the TEDDY study is associated with reduced risk of DKA at diagnosis of type 1 diabetes in young children.

  • Received May 31, 2011.
  • Accepted August 17, 2011.

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  1. Diabetes Care
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