Predicting Risk for Diabetic Ketoacidosis in Children Recently Diagnosed with Type 1 Diabetes Using the Risk Index for Diabetic Ketoacidosis

Early identification of children with type 1 diabetes at heightened risk for diabetic ketoacidosis (DKA) is necessary for preventive intervention. The present study aimed to examine whether an automated electronic medical record-based tool (the Risk Index for Diabetic Ketoacidosis [RI-DKA]) can reliably predict risk for future DKA using data obtained from only the first 6 months post diagnosis. Data were extracted for 3946 children who met the inclusion criteria. The RI-DKA showed an acceptable ability to discriminate between children who did and did not go on to experience a subsequent DKA event (area under the curve = 0.75), only slightly below the predictive ability in the RI-DKA validation sample. These findings indicate that the RI-DKA is a valuable tool for identifying at-risk children very early in the course of type 1 diabetes.