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Published on: July 5, 2022

Reducing Diabetic Ketoacidosis in Pediatric Type 1 Diabetes: The Impact of Screening Programs and Early

Yung-Yi Lan1, Rujith Kovinthapillai1, Andrzej Kędzia2

  • 1Center for Medical Education in English, Poznan University of Medical Sciences, 41 Jackowskiego St., 60-512 Poznań, Poland.

Journal of Clinical Medicine
|August 13, 2026
PubMed

Insights

Diabetic ketoacidosis (DKA) at type 1 diabetes (T1D) onset in children can be prevented. Early screening and new immunotherapies, like teplizumab, significantly reduce DKA risk by enabling timely intervention.

Area of Science:

  • Pediatrics
  • Immunology
  • Endocrinology

Background:

  • Diabetic ketoacidosis (DKA) is a frequent, preventable complication at type 1 diabetes (T1D) onset in children.
  • Delayed recognition, socioeconomic factors, and access to care contribute to DKA incidence.
  • Autoantibody screening and disease-modifying therapies offer potential for DKA prevention.

Purpose of the Study:

  • To review evidence on DKA epidemiology, risk factors, screening, and prevention strategies in pediatric T1D.
  • To synthesize findings on immunological interventions for DKA reduction.

Main Methods:

  • A narrative review of literature from PubMed, EMBASE, Scopus, Web of Science, and Google Scholar (2011-2026).
  • Inclusion of clinical studies, guidelines, systematic reviews, meta-analyses, and prevention trials.
  • Integration of evidence to identify DKA determinants and reduction strategies.

Main Results:

  • DKA risk is higher in younger children, those with socioeconomic disadvantage, rural residence, misdiagnosis, or limited care access.
  • Sustained public awareness and community education reduce DKA incidence.
  • Screening programs (TrialNet, TEDDY) and teplizumab show significant DKA reduction and delayed T1D progression.

Conclusions:

  • Integrated strategies including public awareness, autoantibody screening, follow-up, and immunotherapy are crucial for DKA prevention.
  • Coordinated care among healthcare providers and research networks is essential for proactive T1D management.
  • A prevention-oriented model is key to reducing DKA at T1D onset.

Keywords:
DKA preventionautoantibodiesdiabetic ketoacidosisdisease-modifying therapiesimmune modulationpediatric diabetesscreening programstype 1 diabetes

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