An Update on the Incidence and Burden of Diabetic Ketoacidosis in the U.S.

Ramphul, Kamleshun; Joynauth, Jyotsnav

doi:10.2337/dc20-1258

Cited by 51 publications

(44 citation statements)

References 4 publications

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“…Further research should also be encouraged from hospitals to publish data on diabetics having different anti-diabetic treatments so that the relationship between anti-diabetic treatments and severity of COVID-19 can also be explored in the future [ 102 ]. During the pre-COVID-19 era, several patient groups were also associated with higher risks and worse outcome of diabetic ketoacidosis [ 103 ]. Research comparing changes in severity and mortality in those specific patient groups can also help physicians prioritize their resources for a better clinical outcome.…”

Section: Discussionmentioning

confidence: 99%

Hypertension, diabetes mellitus, and cerebrovascular disease predispose to a more severe outcome of COVID-19

Ramphul¹,

Lohana²,

Ramphul³

et al. 2021

Arch Med Sci Atheroscler Dis

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Introduction The world is currently facing the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The total number of cases of coronavirus disease 2019 (COVID-19) is rising daily and no vaccine has yet been approved. While the pathophysiology behind the virus is still being studied, many possible several risk factors using small sample sizes have been found. Material and methods We conducted a pooled analysis using several databases such as Medline, Scopus, Wangfang, Web of Science, Research Square, medrxiv, and Google Scholar to identify studies reporting severe and non-severe groups of COVID-19 patients. The odds ratios as well as the 95% confidence intervals for hypertension, diabetes, and cerebrovascular disease leading to severe COVID-19 were calculated using R-software. Results Fifty-three articles were used for our analysis and they involved 30,935 confirmed cases of COVID-19 from several countries across the world. The odds ratio for severe COVID-19 in hypertensive patients, diabetics, and patients with a history of cerebrovascular disease was 2.58 (95% confidence interval (CI): 2.16–3.08, from 53 studies), 2.17 (95% CI: 1.72–2.74, from 44 studies), and 2.63 (95% CI: 1.80–3.85, from 25 studies), respectively. Conclusions Our analysis confirms that patients with hypertension, diabetes, or cerebrovascular disease are at a higher risk of a severe outcome of COVID-19. It is thus vital for physicians to identify the main risk factors for a severe outcome of this disease.

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Section: Discussionmentioning

confidence: 99%

Hypertension, diabetes mellitus, and cerebrovascular disease predispose to a more severe outcome of COVID-19

Ramphul¹,

Lohana²,

Ramphul³

et al. 2021

Arch Med Sci Atheroscler Dis

Self Cite

View full text Add to dashboard Cite

show abstract

“…DKA is the main reason for the hospitalization of patients with DM (25) and its treatment represents a substantial economic burden in terms of health care costs, both directly and indirectly, ranging from individual to national economy. For example in United Kingdom (UK), the average cost for an episode of diabetic ketoacidosis was £2064 per patient (26) and in the United States of America (USA), the total charges among DKA patients in 2017 were $6,757,748,178, with a mean of $30,836.19 (27).…”

Section: Timely Diagnosis Comprehensive Clinical and Biochemical Eval...mentioning

confidence: 99%

Time to Recovery from Diabetic Ketoacidosis and its Predictors among Adult Diabetic Ketoacidosis Patients in DEBRE MARKOS Referral Hospital, North West Ethiopia, 2021: Retrospective Cohort Study

Temesgen

Miskir

Dessie

et al. 2022

Preprint

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Introduction : Diabetic ketoacidosis is an acute life-threatening complication of diabetes mellitus. With appropriate treatments, diabetic ketoacidosis patients are expected to make a full recovery within 24 hours. Previous studies did not address variables such as duration of diabetic ketoacidosis symptoms, and blood glucose level. In addition, the recovery time and its predictors of diabetic ketoacidosis in adult patients are not well known in Ethiopia. Objective : To assess time to recovery from diabetic ketoacidosis and its predictors among adult diabetic ketoacidosis patients in Debre Markos referral hospital, North West Ethiopia, 2021 Methods: A retrospective cohort study was employed among 452 records of adult diabetic ketoacidosis patients who were admitted starting from January 1, 2016 to January 1, 2021 using their medical registration number. Data were entered into Epi-data version 4.6 and analyzed using Stata version 14. A Kaplan Meier survival curve was used to estimate diabetic ketoacidosis-free survival time. In addition, a generalized log-rank test was utilized to compare diabetic ketoacidosis-free survival time between different categorical explanatory variables. Cox proportional hazards model was used to identify predictors of time to diabetic ketoacidosis recovery time. Variables with a P-value < 0.25 in the bivariable analysis were entered into a multivariable Cox proportional hazards model to identify predictors of recovery time at p<= 0.05. Result: The median time to recovery from diabetic ketoacidosis for all observations was 24 hours. Severity of diabetic ketoacidosis (AHR=0.24, 95%CI=0.16-0.35), duration of diabetic ketoacidosis (AHR=0.46, 95%CI 0.33-0.64), diabetes duration (AHR=1.74, 95%CI 1.35-2.25), and random blood sugar level (AHR=0.64, 95%CI= (0.51-0.79) were significant predictors of recovery time. Conclusion and recommendation: The median time to recovery from diabetic ketoacidosis was relatively prolonged. The hospital shall give special attention to patients with the identified predictors. Further study using a prospective design by including admission pH and admission serum potassium level is advised.

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“…3 and Supplementary Material, part 6 ) ( 15 , 23 , 75 ). For T1D, adult deaths from diabetic ketoacidosis, ∼800 in the U.S. in 2017, emphasize the importance of earlier diagnosis and prevention ( 76 , 77 ).…”

Section: Genetic Implicationsmentioning

confidence: 99%

Diabetes: Concepts of β-Cell Organ Dysfunction and Failure Would Lead to Earlier Diagnoses and Prevention

Charles

Leslie

2021

Diabetes

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As the world endures a viral pandemic superimposed on a diabetes pandemic, the latter incorporates most of the comorbidities associated with the former, thereby exacerbating risk of death in both. An essential approach to both pandemics is prevention and unrealized earlier treatment. Thus, in this Perspective relating to diabetes, we emphasize a paradigm of, first, reversible β-cell organ dysfunction and then irreversible β-cell organ failure, which directly indicate the potential for earlier prevention, also unrealized in current guidelines. Four pillars support this paradigm: epidemiology, pathophysiology, molecular pathology, and genetics. A substantial worldwide knowledge base defines each pillar and informs a more aggressive preventive approach to most forms of the disorder. This analysis seeks to clarify the temporal and therapeutic relationships between lost β-cell function and content, illuminating the potential for earlier diagnoses and, thus, prevention. We also propose that myriad pathways leading to most forms of diabetes converge at the endoplasmic reticulum, where stress can result in β-cell death and content loss. Finally, genetic and nongenetic origins common to major types of diabetes can inform earlier diagnosis and, potentially, prevention, with the aim of preserving β-cell mass.

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An Update on the Incidence and Burden of Diabetic Ketoacidosis in the U.S.

Cited by 51 publications

References 4 publications

Hypertension, diabetes mellitus, and cerebrovascular disease predispose to a more severe outcome of COVID-19

Hypertension, diabetes mellitus, and cerebrovascular disease predispose to a more severe outcome of COVID-19

Time to Recovery from Diabetic Ketoacidosis and its Predictors among Adult Diabetic Ketoacidosis Patients in DEBRE MARKOS Referral Hospital, North West Ethiopia, 2021: Retrospective Cohort Study

Diabetes: Concepts of β-Cell Organ Dysfunction and Failure Would Lead to Earlier Diagnoses and Prevention

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