Association of Diabetic Ketoacidosis in Childhood New-Onset Type 1 Diabetes With Day of Presentation in Germany

Diabetes Care. 2024 Apr 1;47(4):649-652. doi: 10.2337/dc23-1643.

Abstract

Objective: Whether the day of the week on which the child presents affects timely diagnosis and risk of diabetic ketoacidosis (DKA) in children with new-onset type 1 diabetes (T1D) is not known.

Research design and methods: We used data of 30,717 children with new-onset T1D during the last 10 years from the German Prospective Diabetes Registry. We determined the odds ratios of T1D diagnosis and DKA on a weekday, public holiday, and school vacation.

Results: Compared with workdays, the odds ratios of being diagnosed with T1D were lower on weekends (0.39 [95% CI, 0.38-0.41]), public holidays (0.57 [0.53-0.63]), and school vacations (0.83 [0.80-0.85]). The odds of DKA diagnosis were also reduced on weekends (0.55 [0.52-0.59]), public holidays (0.73 [0.63-0.84]), and school vacations (0.85 [0.80-0.90]). Results did not change during the coronavirus 2019 pandemic.

Conclusions: New-onset T1D and DKA in children are more often diagnosed during weekdays than weekends and holidays.

MeSH terms

  • Child
  • Diabetes Mellitus, Type 1* / complications
  • Diabetes Mellitus, Type 1* / diagnosis
  • Diabetes Mellitus, Type 1* / epidemiology
  • Diabetic Ketoacidosis* / diagnosis
  • Diabetic Ketoacidosis* / epidemiology
  • Diabetic Ketoacidosis* / etiology
  • Germany / epidemiology
  • Humans
  • Prospective Studies
  • Registries