Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes in Colorado Children, 2010-2017.
Journal
Diabetes care
ISSN: 1935-5548
Titre abrégé: Diabetes Care
Pays: United States
ID NLM: 7805975
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
received:
01
03
2019
accepted:
24
09
2019
pubmed:
12
10
2019
medline:
15
9
2020
entrez:
12
10
2019
Statut:
ppublish
Résumé
We examined trends in diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes at a large pediatric diabetes center between 2010 and 2017, overlapping with the Affordable Care Act's overhaul of U.S. health care. Colorado residents <18 years old who were diagnosed with type 1 diabetes from 2010 to 2017 and subsequently followed at the Barbara Davis Center for Diabetes were included. Logistic regression models were used to test associations among age, sex, race/ethnicity, insurance, language, year of diagnosis, and rural/nonrural residence and DKA at diagnosis. Linear regression models were used to test the association of each predictor with HbA There were 2,429 subjects who met the inclusion criteria. From 2010 to 2017, the rate of DKA increased from 41 to 58%. It increased from 35.3 to 59.6% among patients with private insurance (odds ratio 1.10 [95% CI 1.05-1.15]; The increase in the rate of DKA in patients with newly diagnosed type 1 diabetes was driven by patients with private insurance. This paradoxically occurred during a time of increasing health insurance coverage. More study is needed to understand the factors driving these changes.
Identifiants
pubmed: 31601639
pii: dc19-0428
doi: 10.2337/dc19-0428
pmc: PMC6925579
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
117-121Informations de copyright
© 2019 by the American Diabetes Association.
Références
JAMA. 2015 Apr 21;313(15):1570-2
pubmed: 25898057
Pediatr Diabetes. 2018 Nov;19(7):1257-1262
pubmed: 30014558
Pediatr Diabetes. 2012 Jun;13(4):308-13
pubmed: 22060727
Diabetes Care. 2009 May;32(5):769-73
pubmed: 19407074
Public Health Rep. 2011 Jan-Feb;126(1):130-5
pubmed: 21337939
Pediatr Diabetes. 2014 Nov;15(7):494-501
pubmed: 24823816
Pediatr Diabetes. 2014 Sep;15 Suppl 20:154-79
pubmed: 25041509
Diabetes Technol Ther. 2019 Feb;21(2):66-72
pubmed: 30657336
BMJ. 2011 Jul 07;343:d4092
pubmed: 21737470
Diabetes Care. 2004 Jun;27(6):1399-404
pubmed: 15161795
Arch Pediatr. 2015 Apr;22(4):343-51
pubmed: 25497364
Diabetologia. 2012 Nov;55(11):2878-94
pubmed: 22933123
Diabetes Care. 2013 Jul;36(7):2035-7
pubmed: 23340893
Diabetes Care. 2019 Mar;42(3):443-449
pubmed: 30573652
N Engl J Med. 2017 Jul 20;377(3):301
pubmed: 28723318
Diabetes Care. 1999 Jan;22(1):7-9
pubmed: 10333896
Diabetes Care. 2011 Nov;34(11):2347-52
pubmed: 21972409
Diabetes Care. 2017 Sep;40(9):1249-1255
pubmed: 28667128
Pediatr Diabetes. 2014 Mar;15(2):118-26
pubmed: 24034790
Pediatrics. 2010 Dec;126 Suppl 3:S111-9
pubmed: 21123473
Pediatr Diabetes. 2017 Nov;18(7):547-552
pubmed: 27726268