Inequities in Diabetic Ketoacidosis Among Patients With Type 1 Diabetes and COVID-19: Data From 52 US Clinical Centers

被引：39

作者：

Ebekozien, Osagie ^{[1
]}

Agarwal, Shivani ^{[2
]}

Noor, Nudrat ^{[1
]}

Albanese-O'Neill, Anastasia ^{[3
]}

Wong, Jenise C. ^{[4
]}

Seeherunvong, Tossaporn ^{[5
]}

Sanchez, Janine ^{[5
]}

DeSalvo, Daniel ^{[6
]}

Lyons, Sarah K. ^{[6
]}

Majidi, Shideh ^{[7
]}

Wood, Jamie R. ^{[8
]}

Acharya, Runa ^{[9
]}

Aleppo, Grazia ^{[10
]}

Sumpter, Kathryn M. ^{[11
]}

Cymbaluk, Anna ^{[6
]}

Shah, Nirali A. ^{[12
]}

Van Name, Michelle ^{[13
]}

Cruz-Aviles, Lisa ^{[13
]}

Alonso, Guy Todd ^{[7
]}

Gallagher, Mary Pat ^{[14
]}

Sanda, Srinath ^{[4
]}

Feuer, Alexis Jamie ^{[15
]}

Cossen, Kristina ^{[16
]}

Rioles, Nicole ^{[1
]}

Jones, Nana-Hawa Yayah ^{[17
]}

Kamboj, Manmohan K. ^{[18
]}

Hirsch, Irl B. ^{[19
]}

机构：

[1] T1D Exchange, Boston, MA 02111 USA

[2] Albert Einstein Coll Med, Fleischer Inst Diabet & Metab, Bronx, NY 10461 USA

[3] Univ Florida, Gainesville, FL 32610 USA

[4] Univ Calif San Francisco, Madison Clin Pediat Diabet, San Francisco, CA 94158 USA

[5] Univ Miami, Miller Sch Med, Maimi, FL 33136 USA

[6] Baylor Coll Med, Texas Childrens Hosp, Houston, TX 77030 USA

[7] Univ Colorado, Barbara Davis Ctr Diabet, Denver, CO 80045 USA

[8] Case Western Reserve Univ, Rainbow Babies & Childrens Hosp, Cleveland, OH 44106 USA

[9] SUNY Upstate Med Univ, Syracuse, NY 13210 USA

[10] Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA

[11] Univ Tennesse Hlth Sci Ctr, Le Bonheur Childrens Hosp, Memphis, TN 38103 USA

[12] Icahn Sch Med Mt Sinai, New York, NY 10029 USA

[13] Yale Sch Med, New Haven, CT 06510 USA

[14] NYU Langone, Hassenfeld Childrens Hosp, New York, NY 10016 USA

[15] Weill Cornell Med, Div Pediat Endocrinol, New York, NY 10065 USA

[16] Emory Univ, Childrens Hosp Atlanta, Sch Med, Atlanta, GA 30329 USA

[17] Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH 45229 USA

[18] Nationwide Children Hosp, Columbus, OH 43205 USA

[19] Univ Washington, Diabet Inst, Seattle, WA 98109 USA

来源：

JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM | 2021年 / 106卷 / 04期

关键词：

COVID-19; DKA; type; 1; diabetes; inequities; STATES;

D O I：

10.1210/clinem/dgaa920

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: We examined whether diabetic ketoacidosis (DKA), a serious complication of type 1 diabetes (T1D) was more prevalent among Non-Hispanic (NH) Black and Hispanic patients with T1D and laboratory-confirmed coronavirus disease 2019 (COVID-19) compared with NH Whites. Method: This is a cross-sectional study of patients with T1D and laboratory-confirmed COVID-19 from 52 clinical sites in the United States, data were collected from April to August 2020. We examined the distribution of patient factors and DKA events across NH White, NH Black, and Hispanic race/ethnicity groups. Multivariable logistic regression analysis was performed to examine the odds of DKA among NH Black and Hispanic patients with T1D as compared with NH White patients, adjusting for potential confounders, such as age, sex, insurance, and last glycated hemoglobin A1c (HbA1c) level. Results: We included 180 patients with T1D and laboratory-confirmed COVID-19 in the analysis. Forty-four percent (n = 79) were NH White, 31% (n = 55) NH Black, 26% (n = 46) Hispanic. NH Blacks and Hispanics had higher median HbA1c than Whites (%-points [IQR]: 11.7 [4.7], P < 0.001, and 9.7 [3.1] vs 8.3 [2.4], P = 0.01, respectively). We found that more NH Black and Hispanic presented with DKA compared to Whites (55% and 33% vs 13%, P < 0.001 and P = 0.008, respectively). After adjusting for potential confounders, NH Black patients continued to have greater odds of presenting with DKA compared with NH Whites (OR [95% CI]: 3.7 [1.4, 10.6]). Conclusion: We found that among T1D patients with COVID-19 infection, NH Black patients were more likely to present in DKA compared with NH White patients. Our findings demonstrate additional risk among NH Black patients with T1D and COVID-19.

引用

页码：E1755 / E1762

页数：8

共 29 条

[21] Admissions for diabetic ketoacidosis in ethnic minority groups in a city hospital [J].