{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T04:26:32Z","timestamp":1773289592214,"version":"3.50.1"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T00:00:00Z","timestamp":1635811200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T00:00:00Z","timestamp":1635811200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Endocr Disord"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The study aimed to evaluate whether the presence of DKA at diabetes diagnosis was associated with poorer metabolic control during a 5-year follow-up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The study included children treated due to newly diagnosed T1D complicated with DKA between 2010 and 2014 with a complete 5-year follow-up. In every case we performed individual matching for age, gender and BMI with a person without DKA (nDKA) on recognition. We collected data regarding treatment modality, HbA<jats:sub>1C<\/jats:sub>, total daily insulin dose, basal insulin and BMI-SDS.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>85 children at the median age of 7.93\u2009years had DKA at diabetes diagnosis. The median pH was 7.19.Continuous subcutaneous insulin infusion (CSII) was used in 87% of participants in each group. No differences in HbA<jats:sub>1C<\/jats:sub> level (7,3%vs7,2%;<jats:italic>p<\/jats:italic>\u2009=\u2009.413) were noted after 5\u2009years of disease duration. The severity of ketoacidosis exerted no significant effect on HbA<jats:sub>1C<\/jats:sub>. The method of insulin delivery at baseline was significantly associated with HbA<jats:sub>1C<\/jats:sub> levels after 5\u2009years of observation, \u03b2<jats:sub>CSII<\/jats:sub>\u2009=\u2009\u2212\u20091.46,95%CI[\u2212\u20092.01 to \u2212\u20090.92],<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The presence of DKA at diabetes diagnosis is not associated with deteriorated long-term metabolic control in children using modern technologies. The early implementation of CSII into diabetes treatment may change the effect of DKA and lead to a long-term HbA<jats:sub>1C<\/jats:sub> improvement.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12902-021-00882-8","type":"journal-article","created":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T11:03:03Z","timestamp":1635850983000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Is diabetic ketoacidosis a good predictor of 5-year metabolic control in children with newly diagnosed type 1 diabetes?"],"prefix":"10.1186","volume":"21","author":[{"given":"Kowalczyk","family":"Emilia","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stypu\u0142kowska","family":"Aneta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Majewska","family":"Barbara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jarz\u0119bowska","family":"Ma\u0142gorzata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hoffmann","family":"Aleksandra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bu\u0142a","family":"Paulina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Szypowska","family":"Agnieszka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,11,2]]},"reference":[{"key":"882_CR1","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1111\/j.1399-5448.2010.00689.x","volume":"12","author":"A Szypowska","year":"2011","unstructured":"Szypowska A, Sk\u00f3rka A. The risk factors of ketoacidosis in children with newly diagnosed type 1 diabetes mellitus. Pediatr Diabetes. 2011;12:302\u20136.","journal-title":"Pediatr Diabetes"},{"key":"882_CR2","doi-asserted-by":"publisher","first-page":"1530","DOI":"10.1007\/s00125-020-05152-1","volume":"63","author":"V Cherubini","year":"2020","unstructured":"Cherubini V, Grimsmann JM, \u00c5kesson K, et al. Temporal trends in diabetic ketoacidosis at diagnosis of paediatric type 1 diabetes between 2006 and 2016: results from 13 countries in three continents. Diabetologia. 2020;63:1530\u201341.","journal-title":"Diabetologia"},{"key":"882_CR3","doi-asserted-by":"publisher","first-page":"272","DOI":"10.5603\/DK.2018.0029","volume":"7","author":"E Niechcia\u0142","year":"2018","unstructured":"Niechcia\u0142 E, Skowro\u0144ska B, Michalak M, Fichna P. Ketoacidosis at diagnosis of type 1 diabetes in children and adolescents from Wielkopolska province in Poland: prevalence, risk factors and clinical presentation. Clin Diabetol. 2018;7:272\u20138.","journal-title":"Clin Diabetol"},{"key":"882_CR4","doi-asserted-by":"publisher","first-page":"1252","DOI":"10.1111\/dme.13345","volume":"34","author":"A Chobot","year":"2017","unstructured":"Chobot A, Polanska J, Brandt A, et al. Updated 24-year trend of type 1 diabetes incidence in children in Poland reveals a sinusoidal pattern and sustained increase. Diabet Med. 2017;34:1252\u20138.","journal-title":"Diabet Med"},{"key":"882_CR5","doi-asserted-by":"publisher","unstructured":"Szalecki M, Wysocka-Mincewicz M, Ramotowska A, Mazur A, Lisowicz L, Be\u0144-Skowronek I, Sieniawska J, Klonowska B, Charemska D, Nawrotek J, Ja\u0142owiec I, Bossowski A, Jamio\u0142kowska M, Pyr\u017cak B, Miszkurka G, Szypowska A. Epidemiology of type 1 diabetes in Polish children: A multicentre cohort study. Diabetes Metab Res Rev. 2018;34(2). https:\/\/doi.org\/10.1002\/dmrr.2962. Epub 2017 Dec 28.","DOI":"10.1002\/dmrr.2962"},{"key":"882_CR6","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1111\/pedi.12701","volume":"19","author":"JI Wolfsdorf","year":"2018","unstructured":"Wolfsdorf JI, Glaser N, Agus M, et al. ISPAD clinical practice consensus guidelines 2018: diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Pediatr Diabetes. 2018;19:155\u201377.","journal-title":"Pediatr Diabetes"},{"key":"882_CR7","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1055\/s-0044-102090","volume":"50","author":"J Gro\u00dfe","year":"2018","unstructured":"Gro\u00dfe J, Hornstein H, Manuwald U, et al. Incidence of diabetic ketoacidosis of new-onset type 1 diabetes in children and adolescents in different countries correlates with human development index (HDI): an updated systematic review, Meta-analysis, and Meta-regression. Horm Metab Res. 2018;50:209\u201322.","journal-title":"Horm Metab Res"},{"key":"882_CR8","doi-asserted-by":"crossref","unstructured":"Praveen PA, Hockett CW, Ong TC, et al. Diabetic ketoacidosis at diagnosis among youth with type 1 and type 2 diabetes: results from SEARCH (United States) and YDR (India) registries. Pediatr Diabetes. 2021;22:40-6.","DOI":"10.1111\/pedi.12979"},{"key":"882_CR9","doi-asserted-by":"publisher","first-page":"d4092","DOI":"10.1136\/bmj.d4092","volume":"343","author":"JA Usher-Smith","year":"2011","unstructured":"Usher-Smith JA, Thompson MJ, Sharp SJ, Walter FM. Factors associated with the presence of diabetic ketoacidosis at diagnosis of diabetes in children and young adults: a systematic review. BMJ. 2011;343:d4092.","journal-title":"BMJ"},{"key":"882_CR10","doi-asserted-by":"publisher","first-page":"1319","DOI":"10.1007\/s00431-015-2537-1","volume":"174","author":"M Wojcik","year":"2015","unstructured":"Wojcik M, Sudacka M, Wasyl B, et al. Incidence of type 1 diabetes mellitus during 26 years of observation and prevalence of diabetic ketoacidosis in the later years. Eur J Pediatr. 2015;174:1319\u201324.","journal-title":"Eur J Pediatr"},{"key":"882_CR11","doi-asserted-by":"publisher","first-page":"9582793","DOI":"10.1155\/2016\/9582793","volume":"2016","author":"A Szypowska","year":"2016","unstructured":"Szypowska A, Ramotowska A, Grzechnik-Gryziak M, et al. High frequency of diabetic ketoacidosis in children with newly diagnosed type 1 diabetes. J Diabetes Res. 2016;2016:9582793.","journal-title":"J Diabetes Res"},{"key":"882_CR12","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1111\/pedi.12946","volume":"21","author":"B Piccini","year":"2020","unstructured":"Piccini B, Schwandt A, Jefferies C, et al. Association of diabetic ketoacidosis and HbA1c at onset with year-three HbA1c in children and adolescents with type 1 diabetes: data from the international SWEET registry. Pediatr Diabetes. 2020;21:339\u201348.","journal-title":"Pediatr Diabetes"},{"key":"882_CR13","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1016\/j.jpeds.2009.07.054","volume":"156","author":"S Ghetti","year":"2010","unstructured":"Ghetti S, Lee JK, Sims CE, et al. Diabetic ketoacidosis and memory dysfunction in children with type 1 diabetes. J Pediatr. 2010;156:109\u201314.","journal-title":"J Pediatr"},{"key":"882_CR14","doi-asserted-by":"publisher","first-page":"1554","DOI":"10.2337\/dc13-1904","volume":"37","author":"FJ Cameron","year":"2014","unstructured":"Cameron FJ, Scratch SE, Nadebaum C, et al. Neurological consequences of diabetic ketoacidosis at initial presentation of type 1 diabetes in a prospective cohort study of children. Diabetes Care. 2014;37:1554\u201362.","journal-title":"Diabetes Care"},{"key":"882_CR15","doi-asserted-by":"publisher","first-page":"443","DOI":"10.2337\/dc18-1405","volume":"42","author":"T Aye","year":"2019","unstructured":"Aye T, Mazaika PK, Mauras N, et al. Impact of early diabetic ketoacidosis on the developing brain. Diabetes Care. 2019;42:443\u20139.","journal-title":"Diabetes Care"},{"key":"882_CR16","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1111\/pedi.12809","volume":"20","author":"LM Duca","year":"2019","unstructured":"Duca LM, Reboussin BA, Pihoker C, et al. Diabetic ketoacidosis at diagnosis of type 1 diabetes and glycemic control over time: the SEARCH for diabetes in youth study. Pediatr Diabetes. 2019;20:172\u20139.","journal-title":"Pediatr Diabetes"},{"key":"882_CR17","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1111\/pedi.12737","volume":"19","author":"LA DiMeglio","year":"2018","unstructured":"DiMeglio LA, Acerini CL, Codner E, et al. ISPAD clinical practice consensus guidelines 2018: glycemic control targets and glucose monitoring for children, adolescents, and young adults with diabetes. Pediatr Diabetes. 2018;19:105\u201314.","journal-title":"Pediatr Diabetes"},{"key":"882_CR18","first-page":"1","volume":"15","author":"AR Khanolkar","year":"2018","unstructured":"Khanolkar AR, Amin R, Taylor-Robinson D, et al. Diabetic ketoacidosis severity at diagnosis and glycaemic control in the first year of childhood onset type 1 diabetes\u2014a longitudinal cohort study. Int J Environ Res Public Health. 2018;15:1\u201314.","journal-title":"Int J Environ Res Public Health"},{"key":"882_CR19","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1111\/pedi.12546","volume":"19","author":"S Shalitin","year":"2018","unstructured":"Shalitin S, Fisher S, Yackbovitch-Gavan M, et al. Ketoacidosis at onset of type 1 diabetes is a predictor of long-term glycemic control. Pediatr Diabetes. 2018;19:320\u20138.","journal-title":"Pediatr Diabetes"},{"key":"882_CR20","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1007\/s00125-013-2850-z","volume":"56","author":"S Fredheim","year":"2013","unstructured":"Fredheim S, Johannesen J, Johansen A, et al. Diabetic ketoacidosis at the onset of type 1 diabetes is associated with future HbA1c levels. Diabetologia. 2013;56:995\u20131003.","journal-title":"Diabetologia"},{"key":"882_CR21","doi-asserted-by":"publisher","first-page":"1358","DOI":"10.1001\/jama.2017.13994","volume":"14","author":"B Karges","year":"2017","unstructured":"Karges B, Schwandt A, Heidtmann B, et al. Association of Insulin Pump Therapy vs insulin injection therapy with severe hypoglycemia, ketoacidosis, and glycemic control among children, adolescents, and young adults with type 1 diabetes. JAMA. 2017;14:1358\u201366.","journal-title":"JAMA"},{"key":"882_CR22","doi-asserted-by":"publisher","first-page":"e3086","DOI":"10.1002\/dmrr.3086","volume":"35","author":"K Piechowiak","year":"2019","unstructured":"Piechowiak K, Szypowska A. Physiological factors influencing diabetes control in type 1 diabetes children with insulin pumps from diagnosis. Diabetes Metab Res Rev. 2019;35:e3086.","journal-title":"Diabetes Metab Res Rev"},{"key":"882_CR23","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/S2352-4642(20)30339-4","volume":"1","author":"C Kamrath","year":"2021","unstructured":"Kamrath C, Tittel SR, Kapellen TM, et al. Early versus delayed insulin pump therapy in children with newly diagnosed type 1 diabetes: results from the multicentre, prospective diabetes follow-up DPV registry. Lancet Child Adolesc Health. 2021;1:17\u201325.","journal-title":"Lancet Child Adolesc Health"},{"key":"882_CR24","doi-asserted-by":"publisher","first-page":"358","DOI":"10.4274\/jcrpe.galenos.2019.2019.0014","volume":"4","author":"A Alassaf","year":"2019","unstructured":"Alassaf A, Odeh R, Gharaibeh L, et al. Impact of socioeconomic characteristics on metabolic control in children with type 1 diabetes in a developing country. J Clin Res Pediatr Endocrinol. 2019;4:358\u201365.","journal-title":"J Clin Res Pediatr Endocrinol"},{"key":"882_CR25","doi-asserted-by":"publisher","first-page":"1398","DOI":"10.2337\/dc19-0184","volume":"8","author":"NF Nielsen","year":"2019","unstructured":"Nielsen NF, Gaulke A, Eriksen TM, et al. Socioeconomic inequality in metabolic control among children with type 1 diabetes: a Nationwide longitudinal study of 4,079 Danish children. Diabetes Care. 2019;8:1398\u2013405.","journal-title":"Diabetes Care"}],"container-title":["BMC Endocrine Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-021-00882-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12902-021-00882-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-021-00882-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T11:04:48Z","timestamp":1635851088000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcendocrdisord.biomedcentral.com\/articles\/10.1186\/s12902-021-00882-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,2]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["882"],"URL":"https:\/\/doi.org\/10.1186\/s12902-021-00882-8","relation":{},"ISSN":["1472-6823"],"issn-type":[{"value":"1472-6823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,2]]},"assertion":[{"value":"25 May 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 October 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 November 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The trial was approved by the Ethics Committee of the Medical University of Warsaw (KB\/91\/2011). Written informed consent was obtained from the legal caregivers of all participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"None.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"218"}}