Which People With Diabetic issues and Ketoacidosis Encounter Increased Dying Chance?

Which People With Diabetic issues and Ketoacidosis Encounter Increased Dying Chance?

— Disparities in results, healthcare use for kind 2 compared to style 1 disorder

by Ed Susman , Contributing Writer, MedPage These days

NEW ORLEANS — Clients with variety two diabetic issues (T2D) hospitalized for ketoacidosis experienced a higher mortality amount vs . patients with style one diabetes (T1D), according to a examine of national knowledge.

In the retrospective analyze, the mortality rate for those people with T2D and diabetic ketoacidosis (DKA) arrived in at .85% vs . .2% for individuals with T1D and DKA (P<0.001), reported Shellsea Portillo Canales, MD, of St. Louis University Hospital.

Patients with T2D and DKA also saw a longer length of stay (LOS) in the hospital and incurred higher hospital charges compared with those with T1D and DKA, Portillo Canales told MedPage Today at a poster presentation at the American Association of Clinical Endocrinology annual meeting. Specifically, her group found that for T2D versus T1D (P<0.001 for both):

  • LOS: 3.81 vs 2.97 days
  • Hospital charges: Average $40,433 vs $29,873

“These findings suggest the need for targeted healthcare strategies to address these disparities and improve patient outcomes, emphasizing the importance of personalized care approaches tailored to the specific needs of patients with different types of diabetes,” she stated.

Portillo Canales and colleagues used data from the 2016-2020 National Inpatient Sample Healthcare Cost and Utilization Project Database, and divided patients into two cohorts based on their diabetes type. The study’s primary endpoint of mortality was obtained using multiple logistic regression analysis.

The researchers reported other significant disparities between the two cohorts for multiple factors, including median household income, insurance type, hospital region, bed size, for-profit status, and teaching hospital status.

Portillo Canales noted that patients with T2D more were likely to have comorbidities or complications. For instance, about 45% had a hypertension diagnosis versus 25% of patients with T1D, while about 24% versus 8%, respectively, had obesity, and 8% versus 4% had chronic obstructive pulmonary disease (P<0.001 for all). However, more patients with T1D had an end-stage renal disease diagnosis compared with T2D patients (4% vs 3%, P<0.001).

She explained that “even though we tried to correct for many of these variables, we believe that the outcomes are worse for T2D patients because they have so many more comorbidities,” adding that increased age and higher Charlson Comorbidity Index scores were seen among the those with T2D and DKA in their analysis.

However, Samarth Virmani, MBBS, of Houston Methodist Hospital, advised caution when interpreting the data regarding higher mortality for patients with T2D, DKA, and other comorbidities. The study does not specify “the types of therapy patients may have received, and who was treating them,” he pointed out.

“Some hospitalists, encountering a younger [patient with T1D and DKA]might be more aggressive in their treatment approach in order to prevent complications and death…I am sure that comorbidities play a major role, but there are other factors that need to be considered as well,” Virmani, who was not involved in the study, told MedPage Today.

  • author['full_name']

    Ed Susman is a freelance medical writer based in Fort Pierce, Florida, USA.

Disclosures

Portillo Canales and Virmani disclosed no relationships with industry.

Primary Source

American Association of Clinical Endocrinology

Source Reference: Portillo Canales S, et al “Disparities in outcomes and healthcare utilization for diabetic ketoacidosis among patients with type 1 and type 2 diabetes mellitus: A five-year national retrospective cohort study” AACE 2024.

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