AJ. Eckert, J. Rosenbauer, C. Kamrath, M. Sindichakis, A. Thimm, M. Holder, J. Weiskorn, DP. Lorenz, S. Gonzalves, G. Gemulla, S. Golembowski, U. Ohlenschläger, D. Hüseman, K. Palm, A. Lemmer, V. Lahn, A. Müller, D. Wurm, M. Wütherich, RW. Holl, et al. (2026). Is the Current Screening Availability for Early Stages of Type 1 Diabetes in Germany Related to the Population-Based Frequency of Diabetic Ketoacidosis at Clinical Manifestation in Children and Adolescents. Pediatric diabetes, 2026, 6905472. https://doi.org/10.1155/pedi/6905472

PubMed 41669248

[Abstract]
AIMS: Is the current screening for early-stage type 1 diabetes (T1D) associated with the rate of diabetic ketoacidosis (DKA) at T1D manifestation at population level?

MATERIALS AND METHODS: Children with T1D manifestation in 2015-2023 in Germany, aged 0.5 to <15 years from the multicenter diabetes registry (DPV) were included and allocated to federal states (FSs) based on their residential postal code. The relative risk (RR) with 95% confidence interval for DKA at manifestation of T1D by FS with vs. without screening, and demographic/context factors was calculated using logistic regression models.

RESULTS: 24,408 children (54.3% males) were included with median onset age of 8.8 (quartiles: 5.3; 11.8) years. The RR for DKA was not significantly lower in FS with vs. without screening (RR: 0.96 [0.93-1.03], p = 0.393) overall, but in the sub-group of children with the highest probability of being screened (age 1.75-10.99 years, manifestation in Bavaria from 2020 to 2023, RR: 0.88 [0.80-0.97], p = 0.012). The most important predictor for DKA was manifestation age <3 years (RR: 1.83, [1.66-2.03], p < 0.001).

CONCLUSIONS: Until 2023, current regional screening initiatives for early-stage T1D were not associated with lower frequency of DKA at population level, but might be helpful in the future if the coverage can be markedly increased.