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Risk Factors for Hyperosmolar Hyperglycemic State in Pediatric Type 2 Diabetes
BACKGROUND. There is a paucity of data on the risk factors for the hyperosmolar hyperglycemic state (HHS) compared with diabetic ketoacidosis (DKA) in pediatric type 2 diabetes (T2D). METHODS. We used the national Kids’ Inpatient Database to identify pediatric admissions for DKA and HHS among those...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10445777/ https://www.ncbi.nlm.nih.gov/pubmed/37614411 http://dx.doi.org/10.1155/2023/1318136 |
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author | Everett, Estelle M. Copeland, Timothy Wisk, Lauren E. Chao, Lily C. |
author_facet | Everett, Estelle M. Copeland, Timothy Wisk, Lauren E. Chao, Lily C. |
author_sort | Everett, Estelle M. |
collection | PubMed |
description | BACKGROUND. There is a paucity of data on the risk factors for the hyperosmolar hyperglycemic state (HHS) compared with diabetic ketoacidosis (DKA) in pediatric type 2 diabetes (T2D). METHODS. We used the national Kids’ Inpatient Database to identify pediatric admissions for DKA and HHS among those with T2D in the years 2006, 2009, 2012, and 2019. Admissions were identified using ICD codes. Those aged <9yo were excluded. We used descriptive statistics to summarize baseline characteristics and Chi-squared test and logistic regression to evaluate factors associated with admission for HHS compared with DKA in unadjusted and adjusted models. RESULTS. We found 8,961 admissions for hyperglycemic emergencies in youth with T2D, of which 6% were due to HHS and 94% were for DKA. These admissions occurred mostly in youth 17–20 years old (64%) who were non-White (Black 31%, Hispanic 20%), with public insurance (49%) and from the lowest income quartile (42%). In adjusted models, there were increased odds for HHS compared to DKA in males (OR 1.77, 95% CI 1.42–2.21) and those of Black race compared to those of White race (OR 1.81, 95% CI 1.34–2.44). Admissions for HHS had 11.3-fold higher odds for major or extreme severity of illness and 5.0-fold higher odds for mortality. CONCLUSION. While DKA represents the most admissions for hyperglycemic emergencies among pediatric T2D, those admitted for HHS had higher severity of illness and mortality. Male gender and Black race were associated with HHS admission compared to DKA. Additional studies are needed to understand the drivers of these risk factors. |
format | Online Article Text |
id | pubmed-10445777 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
record_format | MEDLINE/PubMed |
spelling | pubmed-104457772023-08-23 Risk Factors for Hyperosmolar Hyperglycemic State in Pediatric Type 2 Diabetes Everett, Estelle M. Copeland, Timothy Wisk, Lauren E. Chao, Lily C. Pediatr Diabetes Article BACKGROUND. There is a paucity of data on the risk factors for the hyperosmolar hyperglycemic state (HHS) compared with diabetic ketoacidosis (DKA) in pediatric type 2 diabetes (T2D). METHODS. We used the national Kids’ Inpatient Database to identify pediatric admissions for DKA and HHS among those with T2D in the years 2006, 2009, 2012, and 2019. Admissions were identified using ICD codes. Those aged <9yo were excluded. We used descriptive statistics to summarize baseline characteristics and Chi-squared test and logistic regression to evaluate factors associated with admission for HHS compared with DKA in unadjusted and adjusted models. RESULTS. We found 8,961 admissions for hyperglycemic emergencies in youth with T2D, of which 6% were due to HHS and 94% were for DKA. These admissions occurred mostly in youth 17–20 years old (64%) who were non-White (Black 31%, Hispanic 20%), with public insurance (49%) and from the lowest income quartile (42%). In adjusted models, there were increased odds for HHS compared to DKA in males (OR 1.77, 95% CI 1.42–2.21) and those of Black race compared to those of White race (OR 1.81, 95% CI 1.34–2.44). Admissions for HHS had 11.3-fold higher odds for major or extreme severity of illness and 5.0-fold higher odds for mortality. CONCLUSION. While DKA represents the most admissions for hyperglycemic emergencies among pediatric T2D, those admitted for HHS had higher severity of illness and mortality. Male gender and Black race were associated with HHS admission compared to DKA. Additional studies are needed to understand the drivers of these risk factors. 2023 2023-06-09 /pmc/articles/PMC10445777/ /pubmed/37614411 http://dx.doi.org/10.1155/2023/1318136 Text en https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Article Everett, Estelle M. Copeland, Timothy Wisk, Lauren E. Chao, Lily C. Risk Factors for Hyperosmolar Hyperglycemic State in Pediatric Type 2 Diabetes |
title | Risk Factors for Hyperosmolar Hyperglycemic State in Pediatric Type 2 Diabetes |
title_full | Risk Factors for Hyperosmolar Hyperglycemic State in Pediatric Type 2 Diabetes |
title_fullStr | Risk Factors for Hyperosmolar Hyperglycemic State in Pediatric Type 2 Diabetes |
title_full_unstemmed | Risk Factors for Hyperosmolar Hyperglycemic State in Pediatric Type 2 Diabetes |
title_short | Risk Factors for Hyperosmolar Hyperglycemic State in Pediatric Type 2 Diabetes |
title_sort | risk factors for hyperosmolar hyperglycemic state in pediatric type 2 diabetes |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10445777/ https://www.ncbi.nlm.nih.gov/pubmed/37614411 http://dx.doi.org/10.1155/2023/1318136 |
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