{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T03:55:46Z","timestamp":1790654146293,"version":"4.1.0"},"reference-count":55,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100019009","name":"Fondation Francophone pour la Recherche sur le Diab\u00e8te","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019009","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008966","name":"Soci\u00e9t\u00e9 Francophone du Diab\u00e8te","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008966","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020669","name":"F\u00e9d\u00e9ration Fran\u00e7aise des Diab\u00e9tiques","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020669","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014592","name":"Insulet Corporation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014592","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016304","name":"Medtronic","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016304","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015769","name":"Dexcom","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015769","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004719","name":"LifeScan","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004719","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Diabetic ketoacidosis (DKA) is a major acute complication of Type 1 diabetes (T1D). The SFDT1\u2010DKA study aims to describe the real\u2010world burden, sociodemographic, and clinical characteristics associated with DKA for people with T1D in France.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included participants from the French SFDT1 prospective cohort. The index date corresponded to the most\u2010recent SFDT1 visit, between January 1st 2023 and December 31st 2024. Sociodemographic and clinical data were collected, along with DKA and severe hypoglycemic episodes (SHE) in the 12\u2009months prior to the index date.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 2685 participants, 51.4% male, mean age 36.8\u2009years, mean age at diagnosis 16.1\u2009years, mean T1D duration 20.7\u2009years. The proportion of participants with \u2265\u20091 DKA events in the 12\u2009months prior to the index date was 4.5% [95% CI 3.8%; 5.4%] and associated with younger age (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), younger age at T1D diagnosis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015), shorter T1D duration (&lt;\u20090.001) and higher HbA1c (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). DKA rates were highest in 18\u201324\u2009year olds (10.3% [95% CI 7.5%; 13.7%] of this age group). Automated insulin delivery (AID) was associated with reduced DKA compared to open\u2010loop systems (3.1% vs. 5.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034). CGM users had lower DKA rates versus self\u2010monitoring of blood glucose (SMBG) (4.3% vs. 8.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034). Participants with \u2265\u20091 DKA events in the previous 12\u2009months had increased SHEs (27.0% vs. 8.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DKA is a significant acute complication for people with T1D in France, even on AID. Our study identified people with T1D for whom education on ketone monitoring and prevention of DKA and SHE is emphasised.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71383","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T03:10:37Z","timestamp":1790651437000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010World Burden of Diabetic Ketoacidosis in Type 1 Diabetes in the French\n                    <scp>SFDT1<\/scp>\n                    Cohort: The\n                    <scp>SFDT1<\/scp>\n                    \u2010\n                    <scp>DKA<\/scp>\n                    Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7991-0741","authenticated-orcid":false,"given":"Jean\u2010Pierre","family":"Riveline","sequence":"first","affiliation":[{"name":"Centre Universitaire de Diab\u00e9tologie et de ses Complications AP\u2010HP, H\u00f4pital Lariboisi\u00e8re  Paris France"},{"name":"Universit\u00e9 Paris Cit\u00e9  Paris France"},{"name":"INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Potier","sequence":"additional","affiliation":[{"name":"APHP, Bichat Hospital, Diabetology Department Universit\u00e9 Paris Cit\u00e9, INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fleur","family":"Levrat\u2010Guillen","sequence":"additional","affiliation":[{"name":"Abbott Ltd.  Maidenhead UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Chesters","sequence":"additional","affiliation":[{"name":"Abbott Ltd.  Maidenhead UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"Bagel","sequence":"additional","affiliation":[{"name":"e\u2010Health Services Sano\u00efa  Aubagne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Joubert","sequence":"additional","affiliation":[{"name":"Diabetes Care Unit Caen University Hospital, UNICAE  Caen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5033-5966","authenticated-orcid":false,"given":"Guy","family":"Fagherazzi","sequence":"additional","affiliation":[{"name":"Deep Digital Phenotyping Research Unit, Department of Precision Health Luxembourg Institute of Health  Strassen Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8785-3385","authenticated-orcid":false,"given":"Emmanuel","family":"Cosson","sequence":"additional","affiliation":[{"name":"Department of Endocrinology\u2010Diabetology\u2010Nutrition, AP\u2010HP GHUPSSD, Avicenne Hospital Universit\u00e9 Paris 13, Sorbonne Paris Cit\u00e9, CRNH\u2010IdF, CSO Ile de France Nord  Bobigny France"},{"name":"Universit\u00e9 Sorbonne Paris Nord and Universit\u00e9 Paris Cit\u00e9, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN)  Bobigny 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