TY - JOUR
T1 - Inequities in Diabetic Ketoacidosis among Patients with Type 1 Diabetes and COVID-19
T2 - Data from 52 US Clinical Centers
AU - Ebekozien, Osagie
AU - Agarwal, Shivani
AU - Noor, Nudrat
AU - Albanese-O'Neill, Anastasia
AU - Wong, Jenise C.
AU - Seeherunvong, Tossaporn
AU - Sanchez, Janine
AU - Desalvo, Daniel
AU - Lyons, Sarah K.
AU - Majidi, Shideh
AU - Wood, Jamie R.
AU - Acharya, Runa
AU - Aleppo, Grazia
AU - Sumpter, Kathryn M.
AU - Cymbaluk, Anna
AU - Shah, Nirali A.
AU - Van Name, Michelle
AU - Cruz-Aviles, Lisa
AU - Alonso, Guy Todd
AU - Gallagher, Mary Pat
AU - Sanda, Srinath
AU - Feuer, Alexis Jamie
AU - Cossen, Kristina
AU - Rioles, Nicole
AU - Jones, Nana Hawa Yayah
AU - Kamboj, Manmohan K.
AU - Hirsch, Irl B.
N1 - Funding Information:
The Helmsley Charitable Trust funds the T1D Exchange QI Collaborative. The T1D Exchange received financial support for this study from Abbott Diabetes, JDRF, Dexcom, Medtronic, Insulet Corporation, Lilly, and Tandem Diabetes Care. S.A. receives funding from the NIDDK (#K23115896-02 and # P30DK111022).
Publisher Copyright:
© 2020 The Author(s) 2020. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
PY - 2021/4/1
Y1 - 2021/4/1
N2 - 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.
AB - 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.
KW - COVID-19
KW - DKA
KW - inequities
KW - type 1 diabetes
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U2 - 10.1210/clinem/dgaa920
DO - 10.1210/clinem/dgaa920
M3 - Article
C2 - 33410917
AN - SCOPUS:85103607850
SN - 0021-972X
VL - 106
SP - E1755-E1762
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 4
ER -
