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.