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Predicting Risk for Diabetic Ketoacidosis in Children Recently Diagnosed with Type 1 Diabetes Using the Risk Index
David D Schwartz1, Madhav Erraguntla2, Ashwin Raja Shanmuga Raja2
1Division of Psychology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
Diabetes Technology & Therapeutics
|June 24, 2026
Summary
Early identification of children with type 1 diabetes is crucial. A new tool, the Risk Index for Diabetic Ketoacidosis (RI-DKA), effectively predicts future diabetic ketoacidosis (DKA) risk using early medical records.
Area of Science:
- Pediatric Endocrinology
- Diabetes Management
- Clinical Informatics
Background:
- Diabetic ketoacidosis (DKA) is a serious complication in children with type 1 diabetes.
- Early identification of at-risk children is vital for implementing preventive strategies.
Purpose of the Study:
- To evaluate the predictive accuracy of the Risk Index for Diabetic Ketoacidosis (RI-DKA) tool.
- To determine if RI-DKA can reliably predict future DKA risk using data from the first six months post-diagnosis in pediatric patients.
Main Methods:
- Retrospective analysis of electronic medical record data from 3946 children diagnosed with type 1 diabetes.
- Utilized the RI-DKA tool, an automated electronic medical record-based system.
- Assessed the tool's discriminative ability using the area under the curve (AUC).
Main Results:
- The RI-DKA demonstrated acceptable discrimination between children who did and did not develop subsequent DKA (AUC = 0.75).
- The predictive performance was comparable to previous validation studies.
- The tool effectively identified children at risk for DKA early in their disease course.
Conclusions:
- The RI-DKA is a valuable and reliable tool for the early identification of children with type 1 diabetes at high risk for DKA.
- This early detection facilitates timely preventive interventions, potentially reducing DKA incidence.
- The tool's effectiveness using limited early data supports its clinical utility.
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