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

OBJECTIVE-Young children have an unacceptably high prevalence of diabetic ketoacidosis (DKA) at the clinical diagnosis of type I. 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 andlt;2 and andlt;5 years compared with population-based incidence studies and registries. less thanbrgreater than less thanbrgreater thanRESEARCH 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). less thanbrgreater than less thanbrgreater thanRESULTS-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 andlt;2 years of age at onset, DKA prevalence in TEDDY participants was significantly lower than in all comparative registries (German DPV Register, P andlt; 0.0001; Swediabkids, P = 0.02; SEARCH, P andlt; 0.0001; Finnish Register, P andlt; 0.0001). The prevalence of DKA in TEDDY children diagnosed at andlt;5 years of age (13.1%) was significantly lower compared with SEARCH (36.4%) (P andlt; 0.0001) and the German DPV Register (32.2%) (P andlt; 0.0001) but not compared with Swediabkids or the Finnish Register. less thanbrgreater than less thanbrgreater thanCONCLUSIONS-Participation in the TEDDY study is associated with reduced risk of DMA at diagnosis of type 1 diabetes in young children.Funding Agencies|National Institute of Diabetes and Digestive and Kidney Diseases|DK-63829DK-63861DK-63821DK-63865DK-63863DK-63836DK-63790HHSN267200700014C|National Institute of Child Health and Human Development||National Institute of Environmental Health Sciences||Juvenile Diabetes Research Foundation||Centers for Disease Control and Prevention||Centers for Disease Control and Prevention|00097DP-05-069DP-10-001|National Institute of Diabetes and Digestive and Kidney Diseases||Bundesministerium fuer Bildung und Forschung Competence Net Diabetes|FKZ 01G10859|Kaiser Permanente Southern California|U48/CCU919219U01 DP000246U18DP002714|University of Colorado Denver|U48/CCU819241-3U01 DP000247U18DP000247-06A1|Kuakini Medical Center|U58CCU919256U01 DP000245|Childrens Hospital Medical Center (Cincinnati)|U48/CCU519239U01 DP0002481U18DP002709|University of North Carolina at Chapel Hill|U48/CCU419249U01 DP000254U18DP002708-01|University of Washington School of Medicine|U58/CCU019235-4U01 DP000244U18DP002710-01|Wake Forest University School of Medicine|U48/CCU919219U01 DP000250200-2010-35171|