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Trends in Type 1 Diabetic Ketoacidosis During COVID-19 Surges at 7 US Centers: Highest Burden on non-Hispanic Black Patients

CONTEXT: The impact of the COVID-19 pandemic on individuals with type 1 diabetes remains poorly defined. OBJECTIVE: We examined United States trends in diabetic ketoacidosis (DKA) among individuals with type 1 diabetes (T1D) during the COVID-19 pandemic at 7 large US medical centers and factors asso...

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Autores principales: Lavik, Andrew R, Ebekozien, Osagie, Noor, Nudrat, Alonso, G Todd, Polsky, Sarit, Blackman, Scott M, Chen, Justin, Corathers, Sarah D, Demeterco-Berggren, Carla, Gallagher, Mary Pat, Greenfield, Margaret, Garrity, Ashley, Rompicherla, Saketh, Rapaport, Robert, Yayah Jones, Nana-Hawa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8992309/
https://www.ncbi.nlm.nih.gov/pubmed/35380700
http://dx.doi.org/10.1210/clinem/dgac158
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author Lavik, Andrew R
Ebekozien, Osagie
Noor, Nudrat
Alonso, G Todd
Polsky, Sarit
Blackman, Scott M
Chen, Justin
Corathers, Sarah D
Demeterco-Berggren, Carla
Gallagher, Mary Pat
Greenfield, Margaret
Garrity, Ashley
Rompicherla, Saketh
Rapaport, Robert
Yayah Jones, Nana-Hawa
author_facet Lavik, Andrew R
Ebekozien, Osagie
Noor, Nudrat
Alonso, G Todd
Polsky, Sarit
Blackman, Scott M
Chen, Justin
Corathers, Sarah D
Demeterco-Berggren, Carla
Gallagher, Mary Pat
Greenfield, Margaret
Garrity, Ashley
Rompicherla, Saketh
Rapaport, Robert
Yayah Jones, Nana-Hawa
author_sort Lavik, Andrew R
collection PubMed
description CONTEXT: The impact of the COVID-19 pandemic on individuals with type 1 diabetes remains poorly defined. OBJECTIVE: We examined United States trends in diabetic ketoacidosis (DKA) among individuals with type 1 diabetes (T1D) during the COVID-19 pandemic at 7 large US medical centers and factors associated with these trends. METHODS: We compared DKA events among children and adults with T1D during COVID-19 surge 1 (March-May 2020) and COVID-19 surge 2 (August-October 2020) to the same periods in 2019. Analysis was performed using descriptive statistics and chi-square tests. RESULTS: We found no difference in the absolute number of T1D patients experiencing DKA in 2019 vs 2020. However, a higher proportion of non-Hispanic Black (NHB) individuals experienced DKA in 2019 than non-Hispanic White (NHW) individuals (44.6% vs 16.0%; P < .001), and this disparity persisted during the COVID-19 pandemic (48.6% vs 18.6%; P < .001). DKA was less common among patients on continuous glucose monitor (CGM) or insulin pump in 2020 compared to 2019 (CGM: 13.2% vs 15.0%, P < .001; insulin pump: 8.0% vs 10.6%, P < .001). In contrast to annual DKA totals, a higher proportion of patients had DKA during COVID-19 surges 1 and 2 compared to the same months in 2019 (surge 1: 7.1% vs 5.4%, P < .001; surge 2: 6.6% vs 5.7%, P = .001). CONCLUSION: DKA frequency increased among T1D patients during COVID-19 surges with highest frequency among NHB patients. DKA was less common among patients using CGM or insulin pumps. These findings highlight the urgent need for improved strategies to prevent DKA among patients with T1D—not only under pandemic conditions, but under all conditions—especially among populations most affected by health inequities.
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spelling pubmed-89923092022-04-12 Trends in Type 1 Diabetic Ketoacidosis During COVID-19 Surges at 7 US Centers: Highest Burden on non-Hispanic Black Patients Lavik, Andrew R Ebekozien, Osagie Noor, Nudrat Alonso, G Todd Polsky, Sarit Blackman, Scott M Chen, Justin Corathers, Sarah D Demeterco-Berggren, Carla Gallagher, Mary Pat Greenfield, Margaret Garrity, Ashley Rompicherla, Saketh Rapaport, Robert Yayah Jones, Nana-Hawa J Clin Endocrinol Metab Clinical Research Article CONTEXT: The impact of the COVID-19 pandemic on individuals with type 1 diabetes remains poorly defined. OBJECTIVE: We examined United States trends in diabetic ketoacidosis (DKA) among individuals with type 1 diabetes (T1D) during the COVID-19 pandemic at 7 large US medical centers and factors associated with these trends. METHODS: We compared DKA events among children and adults with T1D during COVID-19 surge 1 (March-May 2020) and COVID-19 surge 2 (August-October 2020) to the same periods in 2019. Analysis was performed using descriptive statistics and chi-square tests. RESULTS: We found no difference in the absolute number of T1D patients experiencing DKA in 2019 vs 2020. However, a higher proportion of non-Hispanic Black (NHB) individuals experienced DKA in 2019 than non-Hispanic White (NHW) individuals (44.6% vs 16.0%; P < .001), and this disparity persisted during the COVID-19 pandemic (48.6% vs 18.6%; P < .001). DKA was less common among patients on continuous glucose monitor (CGM) or insulin pump in 2020 compared to 2019 (CGM: 13.2% vs 15.0%, P < .001; insulin pump: 8.0% vs 10.6%, P < .001). In contrast to annual DKA totals, a higher proportion of patients had DKA during COVID-19 surges 1 and 2 compared to the same months in 2019 (surge 1: 7.1% vs 5.4%, P < .001; surge 2: 6.6% vs 5.7%, P = .001). CONCLUSION: DKA frequency increased among T1D patients during COVID-19 surges with highest frequency among NHB patients. DKA was less common among patients using CGM or insulin pumps. These findings highlight the urgent need for improved strategies to prevent DKA among patients with T1D—not only under pandemic conditions, but under all conditions—especially among populations most affected by health inequities. Oxford University Press 2022-03-30 /pmc/articles/PMC8992309/ /pubmed/35380700 http://dx.doi.org/10.1210/clinem/dgac158 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Clinical Research Article
Lavik, Andrew R
Ebekozien, Osagie
Noor, Nudrat
Alonso, G Todd
Polsky, Sarit
Blackman, Scott M
Chen, Justin
Corathers, Sarah D
Demeterco-Berggren, Carla
Gallagher, Mary Pat
Greenfield, Margaret
Garrity, Ashley
Rompicherla, Saketh
Rapaport, Robert
Yayah Jones, Nana-Hawa
Trends in Type 1 Diabetic Ketoacidosis During COVID-19 Surges at 7 US Centers: Highest Burden on non-Hispanic Black Patients
title Trends in Type 1 Diabetic Ketoacidosis During COVID-19 Surges at 7 US Centers: Highest Burden on non-Hispanic Black Patients
title_full Trends in Type 1 Diabetic Ketoacidosis During COVID-19 Surges at 7 US Centers: Highest Burden on non-Hispanic Black Patients
title_fullStr Trends in Type 1 Diabetic Ketoacidosis During COVID-19 Surges at 7 US Centers: Highest Burden on non-Hispanic Black Patients
title_full_unstemmed Trends in Type 1 Diabetic Ketoacidosis During COVID-19 Surges at 7 US Centers: Highest Burden on non-Hispanic Black Patients
title_short Trends in Type 1 Diabetic Ketoacidosis During COVID-19 Surges at 7 US Centers: Highest Burden on non-Hispanic Black Patients
title_sort trends in type 1 diabetic ketoacidosis during covid-19 surges at 7 us centers: highest burden on non-hispanic black patients
topic Clinical Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8992309/
https://www.ncbi.nlm.nih.gov/pubmed/35380700
http://dx.doi.org/10.1210/clinem/dgac158
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