Admissions for diabetic ketoacidosis in ethnic minority groups in a city hospital

Ebenezer Nyenwe, Raghu Loganathan, Steve Blum, Donald Ezuteh, David Erani, Marcia Palace, Chukwuma Ogugua

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Abstract

Hospitalization for diabetic ketoacidosis (DKA) is increasing, perhaps due to the rising incidence of DKA in patients with type 2 diabetes mellitus (T2DM). Ethnic minority groups are at increased risk for T2DM. This study aimed at elucidating the characteristics of patients with ketosis-prone diabetes in a predominantly ethnic minority population. We performed a retrospective analysis of adults admitted with DKA at the Bronx Lebanon Hospital Center, Bronx, NY over 3 years. The patients were divided into cohorts based on type of diabetes and ethnicity. The cohorts were described and compared using statistical methods. We recorded 219 cases of DKA in 168 patients, 97% of whom were African American or Hispanic. Fifty-three (32%) patients had T2DM. New-onset diabetes, which was more common in T2DM (P < .0001), and African Americans (P = .008), occurred in 42 patients (25%). Readmission with DKA was more common in the Hispanic patients with type 1 diabetes mellitus (T1DM) (P = .0001). Type 2 diabetes mellitus was more prevalent in the African Americans (P = .04). Patients with T1DM had more severe acidosis than patients with T2DM (lower pH and bicarbonate and larger anion gap; P = .03, .02, and .005, respectively). Creatinine level was higher in patients with T2DM (P = .04) who were also less likely to have identifiable precipitating causes (P = .02). Hemoglobin A1c level was higher in patients with new-onset diabetes (P < .05), but did not differ between those with T1DM and T2DM. Mortality, which was 2%, occurred only in the African Americans with T2DM. We conclude that DKA is an important mode of initial presentation of T2DM, with new-onset T2DM accounting for about 60% of all new cases of DKA. African American patients with T2DM, in comparison with the Hispanic patients, are more susceptible to developing DKA. Diabetic ketoacidosis could occur in T2DM without any identifiable precipitant. The rising incidence of DKA may be attributable to its increasing occurrence in T2DM; therefore, measures aimed at primary prevention of T2DM are worthwhile.

Original languageEnglish (US)
Pages (from-to)172-178
Number of pages7
JournalMetabolism: clinical and experimental
Volume56
Issue number2
DOIs
StatePublished - Feb 1 2007

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Diabetic Ketoacidosis
Minority Groups
Urban Hospitals
Ethnic Groups
Type 2 Diabetes Mellitus
African Americans
Type 1 Diabetes Mellitus
Hispanic Americans
Lebanon
Ketosis
Acid-Base Equilibrium
Incidence
Primary Prevention
Bicarbonates
Acidosis

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Admissions for diabetic ketoacidosis in ethnic minority groups in a city hospital. / Nyenwe, Ebenezer; Loganathan, Raghu; Blum, Steve; Ezuteh, Donald; Erani, David; Palace, Marcia; Ogugua, Chukwuma.

In: Metabolism: clinical and experimental, Vol. 56, No. 2, 01.02.2007, p. 172-178.

Research output: Contribution to journalArticle

Nyenwe, Ebenezer ; Loganathan, Raghu ; Blum, Steve ; Ezuteh, Donald ; Erani, David ; Palace, Marcia ; Ogugua, Chukwuma. / Admissions for diabetic ketoacidosis in ethnic minority groups in a city hospital. In: Metabolism: clinical and experimental. 2007 ; Vol. 56, No. 2. pp. 172-178.
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