Pradeep A Praveen1, Christine W Hockett2, Toan C Ong3, Anandakumar Amutha4, Scott P Isom5, Elizabeth T Jensen6, Viswanathan Mohan4, Dana A Dabelea2, Ralph B D'Agostino5, Richard F Hamman2, Elizabeth J Mayer-Davis7, Jean M Lawrence8, Lawrence M Dolan9, Michael G Kahn3, Sri Venkata Madhu10, Nikhil Tandon1. 1. Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India. 2. Lifecourse Epidemiology of Adiposity and Diabetes Center, Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado. 3. Department of Pediatrics, University of Colorado, Aurora, Colorado. 4. Dr. Mohan's Diabetes Specialties Centre and Madras Diabetes Research Foundation, Chennai, India. 5. Department of Biostatistics and Bioinformatics, Wake Forest School of Medicine, Winston-Salem, North Carolina. 6. Department of Epidemiology, Wake Forest School of Medicine, Winston-Salem, North Carolina. 7. Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina. 8. Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California. 9. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio. 10. University College of Medical Science, GTB Hospital, Delhi, India.
Abstract
BACKGROUND: There is significant global variation in the prevalence of diabetic ketoacidosis (DKA) at diagnosis among youth with type 1 diabetes (T1D). However, data for youth with type 2 diabetes (T2D) are limited, even in developed countries. We compared the prevalence of DKA at diagnosis among individuals with T1D and T2D from the SEARCH for Diabetes in Youth (SEARCH) and the Registry of Youth Onset Diabetes in India (YDR) registries. METHODS: We harmonized the SEARCH and YDR registries to the structure and terminology in the Observational Medical Outcome Partnership Common Data Model. Data used were from youth with T1D and T2D diagnosed before 20 years and newly diagnosed between 2006 and 2012 in YDR and 2009 and 2012 in SEARCH. RESULTS: There were 5366 US youth (4078 with T1D, 1288 with T2D) and 2335 Indian youth (2108 with T1D, 227 with T2D). More than one third of T1D youth enrolled in SEARCH had DKA at diagnosis which was significantly higher than in YDR (35.3% vs 28.7%, P < .0001). The burden of DKA in youth with T1D was significantly higher among younger age groups; this relationship was similar across registries (P = .4). The prevalence of DKA among T2D in SEARCH and YDR were 5.5% and 6.6% respectively (P = .4). CONCLUSIONS: There is significant burden of DKA at diagnosis with T1D among youth from United States and India, especially among the younger age groups. The reasons for this high prevalence are largely unknown but are critical to developing interventions to prevent DKA at diagnosis.
BACKGROUND: There is significant global variation in the prevalence of diabetic ketoacidosis (DKA) at diagnosis among youth with type 1 diabetes (T1D). However, data for youth with type 2 diabetes (T2D) are limited, even in developed countries. We compared the prevalence of DKA at diagnosis among individuals with T1D and T2D from the SEARCH for Diabetes in Youth (SEARCH) and the Registry of Youth Onset Diabetes in India (YDR) registries. METHODS: We harmonized the SEARCH and YDR registries to the structure and terminology in the Observational Medical Outcome Partnership Common Data Model. Data used were from youth with T1D and T2D diagnosed before 20 years and newly diagnosed between 2006 and 2012 in YDR and 2009 and 2012 in SEARCH. RESULTS: There were 5366 US youth (4078 with T1D, 1288 with T2D) and 2335 Indian youth (2108 with T1D, 227 with T2D). More than one third of T1D youth enrolled in SEARCH had DKA at diagnosis which was significantly higher than in YDR (35.3% vs 28.7%, P < .0001). The burden of DKA in youth with T1D was significantly higher among younger age groups; this relationship was similar across registries (P = .4). The prevalence of DKA among T2D in SEARCH and YDR were 5.5% and 6.6% respectively (P = .4). CONCLUSIONS: There is significant burden of DKA at diagnosis with T1D among youth from United States and India, especially among the younger age groups. The reasons for this high prevalence are largely unknown but are critical to developing interventions to prevent DKA at diagnosis.
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