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Younger children (&lt;\u20092\u00a0years) had tenfold risk of DKA, compared to older children (12.1\u201315\u00a0years) (OR\u2009=\u200910.8, 95% CI: 1.0\u2013116.9,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.05). Fasting c-peptide levels were lower in the DKA group (OR\u2009=\u20090.26, 95% CI\u2009=\u20090.07\u20130.89,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.033). The number of anti-pancreatic antibodies at disease onset did not show any significant correlations with the presence (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.889) or severity of DKA (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.863). All patients with multiple autoimmunity (&gt;\u20092 autoimmune diseases plus T1DM) presented with DKA. Familial autoimmunity acted protectively against DKA manifestation (OR\u2009=\u20090.40, 95% CI\u2009=\u20090.16\u20131.0,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.051).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among newly diagnosed T1DM patients, 67.2% presented with DKA. Younger age, lower c-peptide and the presence of associated autoimmunity were predictive factors of the presence and severity of DKA at diagnosis. High degree of suspicion, due to family history, may prevent DKA development and severity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s42000-023-00518-7","type":"journal-article","created":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T05:02:12Z","timestamp":1703653332000},"page":"395-405","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Predictors of the clinical severity of T1DM presentation at diagnosis in children and adolescents with type 1 diabetes mellitus (T1DM)"],"prefix":"10.1007","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5323-2786","authenticated-orcid":false,"given":"Kyriaki","family":"Karavanaki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4997-4968","authenticated-orcid":false,"given":"Anastasia","family":"Korona","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2310-1050","authenticated-orcid":false,"given":"Spyridon","family":"Karanasios","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0476-6586","authenticated-orcid":false,"given":"Lydia","family":"Kossiva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,12,27]]},"reference":[{"key":"518_CR1","doi-asserted-by":"publisher","first-page":"2878","DOI":"10.1007\/s00125-012-2690-2","volume":"55","author":"JA Usher-Smith","year":"2012","unstructured":"Usher-Smith JA, Thompson M, Ercole A, Walter FM (2012) Variation between countries in the frequency of diabetic ketoacidosis at first presentation of type 1 diabetes in children: A systematic review. 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