Study Shows More Children Diagnosed With Type 1 Diabetes During Diabetic Ketoacidosis

Researchers in Poland reviewed medical records from over 7,000 children newly diagnosed with Type 1 diabetes between 2019 and 2022. They focused on how many of these children had developed diabetic ketoacidosis (DKA)—a serious condition where the blood becomes too acidic because the body cannot properly use glucose for energy. After applying their study criteria, they analyzed data from 6,543 children.

Diabetic ketoacidosis is a medical emergency that requires immediate hospital care. It can happen when Type 1 diabetes goes undiagnosed or unmanaged, because without enough insulin, the body breaks down fat too quickly, producing harmful acids called ketones.

The study found that 54.5% of all children in the analysis had DKA when they were diagnosed with Type 1 diabetes. More notably, the frequency increased over time: in 2019, before the pandemic, 47.9% of newly diagnosed children had DKA. This jumped to 58.6% in 2020—the first year of the COVID-19 pandemic—and remained high at 54.0% in 2022.

The researchers noted that the spike during 2020 was larger than they would have predicted based on trends from previous years. They estimated that COVID-19 itself accounted for about a 9 percentage-point increase in DKA cases during the pandemic period.

Beyond simply having DKA more often, children diagnosed during the pandemic were more likely to present with moderate or severe forms of the condition. After the pandemic period ended, the severity of DKA cases decreased, suggesting the pandemic had a specific impact on how ill children were when first diagnosed.

This pattern—higher frequency and greater severity during 2020—aligns with findings from other countries around the world, indicating that the pandemic may have delayed diagnosis and medical care for children showing symptoms of Type 1 diabetes.

DKA is preventable with early diagnosis and proper treatment. High rates of DKA at the time of diagnosis suggest that some children were not recognized as having Type 1 diabetes until their condition became serious. The increase during the pandemic may reflect delayed medical care, reduced access to healthcare, or reduced awareness of Type 1 diabetes symptoms during that period.

Understanding these trends helps healthcare providers and communities think about how to improve early detection of Type 1 diabetes so fewer children develop this dangerous complication at diagnosis.

Source: Frontiers in endocrinology. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.