Screening can reduce DKA at onset by 50%
Diabetic ketoacidosis (DKA) is a serious event, but screening can identify patients who may be at increased risk1
Screening for autoantibodies has been shown to reduce the incidence of DKA at diagnosis of T1D by ≥50%.2,3
Patients who were screened experienced an ~8x lower likelihood of DKA at clinical onset of T1D.4
- ~30% to ~50% of children in the United States experience DKA at the onset of T1D5
- Children with moderate or severe DKA experience a shorter “honeymoon phase” than children who do not present with DKA6
DKA at onset may cause a “metabolic scar” in patients, which can lead to worse metabolic control in the short and longer term.1
Metabolic and physical consequences of DKA at onset
- Lower residual beta-cell function7
- Higher HbA1c for at least 15 years8
- Rare neurological trauma such as cerebral edema9
Early identification can improve outcomes at clinical onset
Screening can help identify patients who might benefit from enhanced clinical vigilance and education, which can improve management at onset.1,4
Percent of children presenting with DKA2
Average A1C at onset in screened vs non‑screened children2
Screening family members can help identify potential patients for upcoming trials and novel therapy candidates
1. Raab J, Haupt F, Scholz M, et al; Fr1da Study Group. Capillary blood islet autoantibody screening for identifying pre-type 1 diabetes in the general population: design and initial results of the Fr1da study. BMJ Open. 2016;6(5):1-12.
2. Barker JM, Goehrig SH, Barriga K, et al; DAISY study. Clinical characteristics of children diagnosed with type 1 diabetes through intensive screening and follow-up. Diabetes Care. 2004;27(6):1399-1404.
3. Elding Larsson H, Vehik K, Bell R, et al. Reduced prevalence of diabetic ketoacidosis at diagnosis of type 1 diabetes in young children participating in longitudinal follow-up. Diabetes Care. 2011;34(11):2347-2353.
4. Winkler C, Schober E, Ziegler A-G, Holl RW. Markedly reduced rate of diabetic ketoacidosis at onset of type 1 diabetes in relatives screened for islet autoantibodies. Pediatr Diabetes. 2012;13(4):308-313.
5. Mencher SR, Frank G, Fishbein J. Diabetic ketoacidosis at onset of type 1 diabetes: rates and risk factors today to 15 years ago. Glob Pediatr Health. 2019;6:1-9.
6. Neylon OM, White M, Connell MAO, Cameron FJ. Insulin-dose-adjusted HbA1c-defined partial remission phase in a paediatric population—when is the honeymoon over? Letter. Diabet Med. 2013;30(5):627-628. doi:10.1111/dme.12097.
7. Fredheim S, Johannesen J, Johansen A, et al; Danish Society for Diabetes in Childhood Adolescence. Diabetic ketoacidosis at the onset of type 1 diabetes is associated with future HbA1c levels. Diabetologia. 2013;56(5):995-1003.
8. Duca LM, Wang B, Rewers M, Rewers A. Diabetic ketoacidosis at diagnosis of type 1 diabetes predicts poor long-term glycemic control. Diabetes Care. 2017;40(9):1249-1255.
9. Aye T, Mazaika PK, Mauras N, et al. Impact of early diabetic ketoacidosis on the developing brain. Diabetes Care. 2019;42(3):443-449.