Evidence mapPaperPMID 39406189Full record

ArticleHormone research in paediatrics2026

Ketone Management in Pediatric Diabetes Centers in the USA: Current Practices and a Call for Improved Standardization.

Brynn E Marks, Seema Meighan, Emily E Fivekiller, Estella Escobar, Cari Berget

Abstract read
In one paragraph

Article in Hormone research in paediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. A Review of Real-World Evidence About the Use of Automated Insulin Delivery Systems in People With Type 1 Diabetes.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2025
    Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Brynn E MarksChildren's Hospital of Philadelphia, Division of Endocrinology and Diabetes, Philadelphia, Pennsylvania, USA.
Seema MeighanChildren's Hospital of Philadelphia, Division of Endocrinology and Diabetes, Philadelphia, Pennsylvania, USA.
Emily E FivekillerBarbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Estella EscobarBarbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Cari BergetBarbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA, cari.berget@cuanschutz.edu.

Funding

Developing a patient-centered psychoeducational tool to realize the potential of diabetes technologiesK23DK129827 · CHILDREN'S HOSP OF PHILADELPHIA · 2025 to 2025
$237k
NIDDK NIH HHS K23 DK129827
6 · The paper itself

Abstract

introductionDiabetic ketoacidosis (DKA) is the leading cause of mortality among youth with type 1 diabetes (T1D). Guidelines for DKA prevention exist; however, specific guidance about when to check ketones and how to manage youth using insulin pumps and automated insulin delivery (AID) systems is lacking.

methodsA 35-item online survey exploring clinical ketone management practices for youth with T1D in the USA was distributed to diabetes healthcare professionals (HCPs). Survey responses, including multiple-choice and Likert scale questions, were summarized and rates of agreement and disagreement (Likert scale 4, 5 vs. 1, 2, 3) are reported.

resultsIn total, 123 HCPs (51% physicians, 26% diabetes educators, 19% nurse practitioners) from 47 institutions completed the survey. Seventy percent worked at academic specialty centers. Ninety-seven percent reported >50% continuous glucose monitoring use in their clinic and 72% reported >50% insulin pump use. Although 79% reported having ketone management protocols, the level and duration of hyperglycemia at which ketone monitoring was advised ranged from >200 to 350 mg/dL and from 0 min to >6 h of duration. While 72% had distinct ketone management protocols for pump users, only 29% had specific protocols for AID. Sixty-two percent agreed that DKA due to infusion site failure was a significant problem in their practice, and 70% agreed there was a need to standardize ketone management guidelines.

conclusionsThe preventable nature and high incidence of DKA highlight the need to build consensus for clinical ketone management and to develop tools to facilitate management, especially as the use of diabetes technologies continues to increase.

Indexed as

Diabetes Mellitus, Type 1Diabetic KetoacidosisInsulin Infusion SystemsKetonesAdolescentChildFemaleHumansMaleSurveys and QuestionnairesUnited StatesKetonesAutomated insulin deliveryDiabetes self-managementDiabetic ketoacidosisInsulin pumpsKetosisType 1 diabetes

Identifiers

PMID39406189
PMCPMC12036702

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.