DOI: 10.2337/dc23-1643 ISSN: 0149-5992

Association of Diabetic Ketoacidosis in Childhood New-Onset Type 1 Diabetes With Day of Presentation in Germany

Clemens Kamrath, Marina Sindichakis, Marie Auzanneau, Silke Schmid, Hugo Segerer, Valentina Lahn, Sven Golembowsky, Dorothee Roessner-Cold, Kristina Rauh, Ulf Manuwald, Reinhard W. Holl
  • Advanced and Specialized Nursing
  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine


Whether the day of the week on which the child presents affects timely diagnosis and risk of diabetic ketoacidosis (DKA) in children with new-onset type 1 diabetes (T1D) is not known.


We used data of 30,717 children with new-onset T1D during the last 10 years from the German Prospective Diabetes Registry. We determined the odds ratios of T1D diagnosis and DKA on a weekday, public holiday, and school vacation.


Compared with workdays, the odds ratios of being diagnosed with T1D were lower on weekends (0.39 [95% CI, 0.38–0.41]), public holidays (0.57 [0.53–0.63]), and school vacations (0.83 [0.80–0.85]). The odds of DKA diagnosis were also reduced on weekends (0.55 [0.52–0.59]), public holidays (0.73 [0.63–0.84]), and school vacations (0.85 [0.80–0.90]). Results did not change during the coronavirus 2019 pandemic.


New-onset T1D and DKA in children are more often diagnosed during weekdays than weekends and holidays.

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