title: Reduced prevalence of diabetic ketoacidosis at diagnosis of type 1 diabetes in young children participating in longitudinal follow-up.
abstract: 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.
  
  
  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.
authors.affiliation: Department of Pediatrics, Skåne University Hospital, Lund University, Malmö, Sweden, helena.larsson@med.lu.se
authors.forename: Helena
authors.initials: H
authors.lastname: Elding Larsson
authors.forename: Kendra
authors.initials: K
authors.lastname: Vehik
authors.forename: Ronny
authors.initials: R
authors.lastname: Bell
authors.forename: Dana
authors.initials: D
authors.lastname: Dabelea
authors.forename: Lawrence
authors.initials: L
authors.lastname: Dolan
authors.forename: Catherine
authors.initials: C
authors.lastname: Pihoker
authors.forename: Mikael
authors.initials: M
authors.lastname: Knip
authors.forename: Riitta
authors.initials: R
authors.lastname: Veijola
authors.forename: Bengt
authors.initials: B
authors.lastname: Lindblad
authors.forename: Ulf
authors.initials: U
authors.lastname: Samuelsson
authors.forename: Reinhard
authors.initials: R
authors.lastname: Holl
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Haller
mesh_terms: D000367:Age Factors; D017668:Age of Onset; D001323:Autoantibodies / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D002675:Child, Preschool; D003625:Data Collection / Q000379:methods; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology; D016883:Diabetic Ketoacidosis / Q000175:diagnosis* / Q000453:epidemiology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007515:Islets of Langerhans / Q000276:immunology; D008137:Longitudinal Studies; D008297:Male; D011159:Population Surveillance; D015995:Prevalence; D012042:Registries / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology
chemical_list: D001323:Autoantibodies; D001786:Blood Glucose