PMID- 28544185
OWN - NLM
STAT- MEDLINE
DCOM- 20181102
LR  - 20181102
IS  - 1399-5448 (Electronic)
IS  - 1399-543X (Linking)
VI  - 19
IP  - 2
DP  - 2018 Mar
TI  - Ketoacidosis at diagnosis of type 1 diabetes: Effect of prospective studies with 
      newborn genetic screening and follow up of risk children.
PG  - 314-319
LID - 10.1111/pedi.12541 [doi]
AB  - 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.
CI  - (c) 2017 The Authors. Pediatric Diabetes published by John Wiley & Sons Ltd.
FAU - Hekkala, Anne M
AU  - Hekkala AM
AUID- ORCID: 0000-0002-3503-226X
AD  - Department of Pediatrics, MRC Oulu, PEDEGO Research Unit, University of Oulu and 
      Oulu University Hospital, Oulu, Finland.
FAU - Ilonen, Jorma
AU  - Ilonen J
AUID- ORCID: 0000-0002-9973-2062
AD  - Immunogenetics Laboratory, University of Turku, and Turku University Hospital, 
      Turku, Finland.
FAU - Toppari, Jorma
AU  - Toppari J
AD  - Department of Pediatrics, University of Turku and Turku University Hospital, 
      Turku, Finland.
AD  - Department of Physiology, Institute of Biomedicine, University of Turku, Turku, 
      Finland.
FAU - Knip, Mikael
AU  - Knip M
AD  - Department of Pediatrics, Tampere University Hospital, Tampere, Finland.
AD  - Children's Hospital, University of Helsinki and Helsinki University Central 
      Hospital, Helsinki, Finland.
AD  - Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, 
      Finland.
AD  - Folkhalsan Research Center, Helsinki, Finland.
FAU - Veijola, Riitta
AU  - Veijola R
AD  - Department of Pediatrics, MRC Oulu, PEDEGO Research Unit, University of Oulu and 
      Oulu University Hospital, Oulu, Finland.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
DEP - 20170523
PL  - Denmark
TA  - Pediatr Diabetes
JT  - Pediatric diabetes
JID - 100939345
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Cohort Studies
MH  - Diabetes Mellitus, Type 1/*diagnosis/epidemiology/genetics/physiopathology
MH  - Diabetic Ketoacidosis/epidemiology/*etiology/prevention & control
MH  - Early Diagnosis
MH  - Female
MH  - Finland/epidemiology
MH  - Follow-Up Studies
MH  - Genetic Predisposition to Disease
MH  - Genetic Testing
MH  - Hospitals, University
MH  - Humans
MH  - Incidence
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - Neonatal Screening
MH  - Prospective Studies
MH  - Registries
MH  - Risk
OTO - NOTNLM
OT  - diagnosis and children
OT  - ketoacidosis
OT  - type 1 diabetes
EDAT- 2017/05/26 06:00
MHDA- 2018/11/06 06:00
CRDT- 2017/05/26 06:00
PHST- 2017/01/30 00:00 [received]
PHST- 2017/04/05 00:00 [revised]
PHST- 2017/04/24 00:00 [accepted]
PHST- 2017/05/26 06:00 [pubmed]
PHST- 2018/11/06 06:00 [medline]
PHST- 2017/05/26 06:00 [entrez]
AID - 10.1111/pedi.12541 [doi]
PST - ppublish
SO  - Pediatr Diabetes. 2018 Mar;19(2):314-319. doi: 10.1111/pedi.12541. Epub 2017 May 
      23.