Evidence mapPaperPMID 41225468Full record

ArticleBMC endocrine disorders2025

Differentiating diabetes type in children and adolescents with ketosis or ketoacidosis at onset: a retrospective analysis of clinical and biochemical markers.

Hongxia Liu, Yan Wang, Miao Wang, Bo Zhang, Caixia Ma, Lianlian Cui, Qianhan Wang, Zhenfeng Cao, Zhongwen Yang, Changsong Shi

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Article in BMC endocrine disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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10 authors.

Hongxia Liu *Department of Pediatrics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan, 450003, China. liufeisuo@163.com.
Yan Wang *Department of Pediatrics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan, 450003, China.
Miao WangDepartment of Pediatrics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan, 450003, China.
Bo ZhangDepartment of Pediatrics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan, 450003, China.
Caixia MaDepartment of Pediatrics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan, 450003, China.
Lianlian CuiDepartment of Pediatrics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan, 450003, China.
Qianhan WangDepartment of Pediatrics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan, 450003, China.
Zhenfeng CaoDepartment of Pediatrics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan, 450003, China.
Zhongwen YangDepartment of Pediatrics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan, 450003, China.
Changsong ShiDepartment of Pediatrics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan, 450003, China.

Funding

Medical Science and Technology Research Program Joint Construction Project of Henan Province LHGJ20210003Medical Science and Technology Research Program Joint Construction Project of Henan Province LHGJ20220043
6 · The paper itself

Abstract

backgroundDistinguishing diabetes diagnosis is fundamental to ensuring proper management of individuals with diabetes, but has been challenging, especially in newly diagnosed diabetes onset with ketosis or ketoacidosis in pediatrics.

methodsA retrospective analysis was conducted on medical records from 2017/1/1 to 2020/4/30 in pediatrics with new-onset diabetes accompanied with ketosis or ketoacidosis. Data was collected at diabetes onset and two years after discharge. Persons with diabetes were classified as type 1 or 2 diabetes (T1DM; T2DM) based on the person’s medication and final diagnosis. The best diagnostic cut-off point was determined using receiver operating characteristic curves (ROCs) between T1DM and T2DM.

resultsAmong 153 children and adolescent with diabetes, 78 (51.0%) were diagnosed as T1DM and 75 (49.0%) were diagnosed as T2DM after two years of follow-up. There were significant differences in sex, age, family history, BMI, systolic and diastolic blood pressure, lipids, uric acid (UA), C-peptide, combined fatty liver ratio and any islet auto-antibody-positive ratio at the time of onset (P < 0.05). Key discriminators identified by ROC analysis included fatty liver, SBP, BMI, and C-peptide levels (fasting, 1-h, and 2-h), with AUCs of 0.79, 0.83, 0.92, 0.94, 0.96, and 0.95 and optimal cut-offs value of 110.5 mmHg, 20.95 kg/m², 0.47 nmol/L (fasting), 0.98 nmol/L (1-h), and 2.03 nmol/L (2-h), respectively.

conclusionsOverall, the most sensitive and specific clinical and biochemical criteria for the diagnostic classification of newly diagnosed diabetes onset with ketosis or ketoacidosis in pediatrics should consider C-peptide, BMI, SBP and fatty liver at the time of onset, which have effective diagnostic values. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

BiomarkersDiabetes Mellitus, Type 1Diabetes Mellitus, Type 2Diabetic KetoacidosisKetosisAdolescentChildChild, PreschoolC-PeptideDiagnosis, DifferentialFemaleFollow-Up StudiesHumansMalePrognosisRetrospective StudiesBiomarkersC-PeptideAdolescentsClinical characteristicsDiabetes typingDiabetic ketoacidosis (DKA)Diabetic ketosis (DK)

Identifiers

PMID41225468
PMCPMC12613522

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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.