University of Oulu

Hekkala AM, Ilonen J, Toppari J, Knip M, Veijola R. Ketoacidosis at diagnosis of type 1 diabetes: Effect of prospective studies with newborn genetic screening and follow up of risk children. Pediatr Diabetes. 2018;19:314–319.

Ketoacidosis at diagnosis of type 1 diabetes : effect of prospective studies with newborn genetic screening and follow up of risk children

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Author: Hekkala, Anne M1; Ilonen, Jorma2; Toppari, Jorma3,4;
Organizations: 1University of Oulu and Oulu University Hospital Department of Pediatrics, MRC Oulu, PEDEGO Research Unit Oulu Finland
2University of Turku, and Turku University Hospital Immunogenetics Laboratory Turku Finland
3University of Turku and Turku University Hospital Department of Pediatrics Turku Finland
4University of Turku Department of Physiology, Institute of Biomedicine Turku Finland
5Tampere University Hospital Department of Pediatrics Tampere Finland
6University of Helsinki and Helsinki University Central Hospital Children's Hospital Helsinki Finland
7University of Helsinki Research Programs Unit, Diabetes and Obesity Helsinki Finland
8Folkhälsan Research Center Helsinki Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
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Language: English
Published: John Wiley & Sons, 2018
Publish Date: 2018-04-12


We studied the frequency of diabetic ketoacidosis (DKA) in children at diagnosis of type 1 diabetes (T1D) in a region where newborn infants have since 1995 been recruited for genetic screening for human leukocyte antigen (HLA)-conferred disease susceptibility and prospective follow up. The aim was to study whether participation in newborn screening and follow up affected the frequency of DKA, and to follow the time trends in DKA frequency. We first included children born in Oulu University Hospital since 1995 when the prospective studies have been ongoing and diagnosed with T1D <15 years by 2015 (study cohort 1, n = 517). Secondly, we included all children diagnosed with T1D <15 years in this center during 2002–2014 (study cohort 2, n = 579). Children who had an increased genetic risk for T1D and participated in prospective follow up had low frequency of DKA at diagnosis (5.0%). DKA was present in 22.7% of patients not screened for genetic risk, 26.7% of those who were screened but had not an increased risk and 23.4% of children with increased genetic risk but who were not followed up. In study cohort 2 the overall frequency of DKA was 18.5% (13.0% in children <5 years, 14.0% in children 5–10 years and 28.6% in children ≥10 years at diagnosis; P<.001). In children <2 years the frequency of DKA was 17.1%. Participation in prospective follow-up studies reduces the frequency of DKA in children at diagnosis of T1D, but genetic screening alone does not decrease DKA risk.

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Series: Pediatric diabetes
ISSN: 1399-543X
ISSN-E: 1399-5448
ISSN-L: 1399-543X
Volume: 19
Pages: 314 - 319
DOI: 10.1111/pedi.12541
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
3121 General medicine, internal medicine and other clinical medicine
Funding: This work is supported by the Oulu University Hospital Research Funds, the Pediatric Research Foundation, Helsinki, Finland, and The Academy of Finland.
Copyright information: © 2017 The Authors. Pediatric Diabetes published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.