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Peer-reviewedCC BY-NC-ND 4.0Diabetes, Obesity & Metabolism

Real‐World Burden of Diabetic Ketoacidosis in Type 1 Diabetes in the French SFDT1 Cohort: The SFDT1‐DKA Study

  • Jean‐Pierre Riveline1,2,3
  • Louis Potier4
  • Fleur Levrat‐Guillen5
  • Christopher Chesters5
  • Arthur Bagel6
  • Michael Joubert7
  • Guy Fagherazzi8
  • Emmanuel Cosson9,10
10 affiliations
  1. 1Centre Universitaire de Diabétologie et de ses Complications AP‐HP, Hôpital Lariboisière Paris France
  2. 2Université Paris Cité Paris France
  3. 3INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades Paris France
  4. 4APHP, Bichat Hospital, Diabetology Department Université Paris Cité, INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades Paris France
  5. 5Abbott Ltd. Maidenhead UK
  6. 6e‐Health Services Sanoïa Aubagne France
  7. 7Diabetes Care Unit Caen University Hospital, UNICAE Caen France
  8. 8Deep Digital Phenotyping Research Unit, Department of Precision Health Luxembourg Institute of Health Strassen Luxembourg
  9. 9Department of Endocrinology‐Diabetology‐Nutrition, AP‐HP GHUPSSD, Avicenne Hospital Université Paris 13, Sorbonne Paris Cité, CRNH‐IdF, CSO Ile de France Nord Bobigny France
  10. 10Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN) Bobigny France
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Abstract

Aims: Diabetic ketoacidosis (DKA) is a major acute complication of Type 1 diabetes (T1D). The SFDT1‐DKA study aims to describe the real‐world burden, sociodemographic, and clinical characteristics associated with DKA for people with T1D in France.

Methods: This retrospective study included participants from the French SFDT1 prospective cohort. The index date corresponded to the most‐recent SFDT1 visit, between January 1st 2023 and December 31st 2024. Sociodemographic and clinical data were collected, along with DKA and severe hypoglycemic episodes (SHE) in the 12 months prior to the index date.

Results: We included 2685 participants, 51.4% male, mean age 36.8 years, mean age at diagnosis 16.1 years, mean T1D duration 20.7 years. The proportion of participants with ≥ 1 DKA events in the 12 months prior to the index date was 4.5% [95% CI 3.8%; 5.4%] and associated with younger age (p < 0.001), younger age at T1D diagnosis (p = 0.015), shorter T1D duration (< 0.001) and higher HbA1c (p = 0.001). DKA rates were highest in 18–24 year olds (10.3% [95% CI 7.5%; 13.7%] of this age group). Automated insulin delivery (AID) was associated with reduced DKA compared to open‐loop systems (3.1% vs. 5.4%, p = 0.034). CGM users had lower DKA rates versus self‐monitoring of blood glucose (SMBG) (4.3% vs. 8.1%, p = 0.034). Participants with ≥ 1 DKA events in the previous 12 months had increased SHEs (27.0% vs. 8.5%, p < 0.001).

Conclusions: DKA is a significant acute complication for people with T1D in France, even on AID. Our study identified people with T1D for whom education on ketone monitoring and prevention of DKA and SHE is emphasised.

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Cite

BibTeXRIS
BibTeX
@article{riveline2026realworld,
  title = {{Real‐World Burden of Diabetic Ketoacidosis in Type 1 Diabetes in the French SFDT1 Cohort: The SFDT1‐DKA Study}},
  author = {Jean‐Pierre Riveline and Louis Potier and Fleur Levrat‐Guillen and Christopher Chesters and Arthur Bagel and Michael Joubert and Guy Fagherazzi and Emmanuel Cosson},
  journal = {Diabetes, Obesity \& Metabolism},
  year = {2026},
  month = sep,
  doi = {10.1111/dom.71383},
  url = {https://doi.org/10.1111/dom.71383},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Real‐World Burden of Diabetic Ketoacidosis in Type 1 Diabetes in the French SFDT1 Cohort: The SFDT1‐DKA Study
AU  - Jean‐Pierre Riveline
AU  - Louis Potier
AU  - Fleur Levrat‐Guillen
AU  - Christopher Chesters
AU  - Arthur Bagel
AU  - Michael Joubert
AU  - Guy Fagherazzi
AU  - Emmanuel Cosson
PY  - 2026
DA  - 2026/09/28
JO  - Diabetes, Obesity & Metabolism
DO  - 10.1111/dom.71383
UR  - https://doi.org/10.1111/dom.71383
AB  - Aims: Diabetic ketoacidosis (DKA) is a major acute complication of Type 1 diabetes (T1D). The SFDT1‐DKA study aims to describe the real‐world burden, sociodemographic, and clinical characteristics associated with DKA for people with T1D in France.  Methods: This retrospective study included participants from the French SFDT1 prospective cohort. The index date corresponded to the most‐recent SFDT1 visit, between January 1st 2023 and December 31st 2024. Sociodemographic and clinical data were collected, along with DKA and severe hypoglycemic episodes (SHE) in the 12 months prior to the index date.  Results: We included 2685 participants, 51.4% male, mean age 36.8 years, mean age at diagnosis 16.1 years, mean T1D duration 20.7 years. The proportion of participants with ≥ 1 DKA events in the 12 months prior to the index date was 4.5% [95% CI 3.8%; 5.4%] and associated with younger age (p < 0.001), younger age at T1D diagnosis (p = 0.015), shorter T1D duration (< 0.001) and higher HbA1c (p = 0.001). DKA rates were highest in 18–24 year olds (10.3% [95% CI 7.5%; 13.7%] of this age group). Automated insulin delivery (AID) was associated with reduced DKA compared to open‐loop systems (3.1% vs. 5.4%, p = 0.034). CGM users had lower DKA rates versus self‐monitoring of blood glucose (SMBG) (4.3% vs. 8.1%, p = 0.034). Participants with ≥ 1 DKA events in the previous 12 months had increased SHEs (27.0% vs. 8.5%, p < 0.001).  Conclusions: DKA is a significant acute complication for people with T1D in France, even on AID. Our study identified people with T1D for whom education on ketone monitoring and prevention of DKA and SHE is emphasised.
SN  - 1462-8902
SN  - 1463-1326
ER  -