Non-Hispanic black patients with type 1 diabetes and COVID-19 were nearly four times more likely to be hospitalized with diabetic ketoacidosis (DKA) than non-Hispanic whites by Le Bonheur Pediatric Endocrinologist Kathryn Sumpter, according to an article published in the Journal of Clinical Endocrinology & Metabolism , MD.
The study looked at 180 patients with type 1 diabetes and laboratory-confirmed COVID-19 at 52 clinical sites, including Le Bonheur Children’s.
The aim of the study was to evaluate cases of DKA, a serious complication of type 1 diabetes, in patients with type 1 diabetes and COVID-19, and to determine whether minorities were at increased risk when they switched to gender, Age, insurance, and last hemoglobin A1c controlled were (HbA1c) levels.
“We know that type 2 diabetes is a risk factor for worse COVID-19 outcomes, but less is known about type 1 diabetes and COVID,” Sumpter said. “This study allowed us to examine the intersection of type 1 diabetes and COVID while also determining the racial inequalities in DKA for these patients.”
Previous studies have shown that COVID-19 disproportionately affects racial and ethnic minorities with higher infection and death rates. The same minority groups with type 1 diabetes have also been shown to be at increased risk for DKA and the associated mortality.
Because of these existing risk factors, it is important to understand how COVID-19 and type 1 diabetes interact and affect outcomes. The results of this study show that non-Hispanic black patients with COVID-19 and type 1 diabetes have an additional risk of DKA beyond the risk of diabetes or minority status.
The results of the study show that non-Hispanic blacks are more likely to have DKA and COVID-19 (55%) than non-Hispanic whites (13%). Hispanics had almost twice the chance of presenting themselves with DKA compared to non-Hispanic whites, who were found not to be statistically significant by researchers.
A combination of factors results in higher DKA rates in type 1 diabetes minority patients with COVID-19 that are related to social and structural risks. Social determinants of health, including income levels, education, racial discrimination and inadequate access to health care, impact these populations with devastating complications from type 1 diabetes and COVID-19. “
Kathryn Sumpter, MD, Pediatric Endocrinologist, Le Bonheur Children’s Hospital
Intervention in these areas is essential to prevent these poor outcomes, which unequally affect minorities, according to the study.
Source:
Le Bonheur Children’s Hospital
Journal reference:
Ebekozien, O., et al. (2020) Inequalities in Diabetic Ketoacidosis in Patients with Type 1 Diabetes and COVID-19: Data from 52 US Clinical Centers. The Journal of Clinical Endocrinology & Metabolism. doi.org/10.1210/clinem/dgaa920.
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