One common misconception surrounding diabetes is that you don’t have to worry about complications until you get older. A recent study conducted at the University of Colorado School of Medicine in Aurora has revealed that currently more young people in America are developing diabetic ketoacidosis (DKA), a potentially life-threatening condition tied to diabetes, at the time of their type 1 diabetes diagnosis compared to 15 years ago.

“Some of the factors associated with DKA at diagnosis are potentially modifiable,” the authors said in a statement. “For example, the association with family history suggests the importance of awareness of diabetic symptoms. However, economic factors are more difficult to modify. Increasing incidence of DKA correlated temporally with an increase in Colorado child poverty prevalence from 10 percent in 2000 to 18 percent in 2012.”

Lead author of the study Dr. Arleta Rewers and her colleagues assessed factors linked to DKA and trends in DKA at type 1 diabetes diagnosis between 1998 and 2012 in Colorado. Data included the medical records of 3,439 young people from the Barbara Davis Center for Diabetes in Denver who had been diagnosed with type 1 diabetes. A total of 1,339 young people — average age of 9.4 years — had also developed DKA at the time of their type 1 diabetes diagnosis.

The total number of young people with DKA at the time of their type 1 diabetes diagnosis increased by 55 percent over the course of the 14-year study. While incidences of DKA only jumped from 30 percent in 1998 to 35 percent in 2007, these rates experienced a noticeable increase to 46 percent in 2012. The research team concluded that delayed access to health care, lower quality of care, and lower income could’ve led to this notable rise in incidences of DKA.

“The recent increase of DKA incidence among youth with private insurance may be related to proliferation of high-deductible health plans,” the authors added. “To our knowledge, this is the only report of increasing incidence of DKA in the developed world. Further research on the reasons for the increase and interventions to decrease the incidence are warranted.”

According to the American Diabetes Association, DKA is characterized by dangerously high blood sugar and the presence of ketones, chemicals produced by the body when it breaks down fat for energy. The body creates ketones when it doesn’t have enough insulin to use glucose. Unfortunately, as ketones begin to buildup they make blood more acidic and poison the body. Although DKA can occur with any type of diabetes, it is considered rare among patients with type 2 diabetes.

Source: Dong F, Slover R, Klingensmith G, Rewers M, Rewers A. Incidence of Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes in Colorado Youth, 1998-2012. JAMA. 2016.