COVID-19 and type 1 diabetes among black people increases diabetic ketoacidosis risk
Non-Hispanic Black people with type 1 diabetes and COVID-19 were nearly four times as likely to go to hospital with diabetic ketoacidosis (DKA) compared to non-Hispanic white people, new research has suggested.
Previous studies have shown that COVID-19 disproportionately affects racial and ethnic minority groups with higher rates of both infection and death.
The same minority groups with type 1 diabetes have also been shown to have an increased risk of DKA and associated mortality, which researchers said makes it critical to understand how COVID-19 and type 1 diabetes interact and affect outcomes.
The new results show that non-Hispanic Black people with COVID-19 and type 1 diabetes have an additional risk of DKA beyond the risk of having diabetes or being of minority status.
Study author Dr Kathryn Sumpter, a pediatric endocrinology at Le Bonheur Children’s Hospital, examined 180 people with type 1 diabetes and COVID-19.
Dr Sumpter said: “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. This study allowed us to examine the intersection of type 1 diabetes and COVID while also determining the racial inequities in DKA for these patients.”
The results of the study show that non-Hispanic Black people were 55 per cent more likely to present with DKA and COVID-19 compared to non-Hispanic whites, who were 13 per cent more likely. Hispanics had almost two times greater odds of presenting with DKA compared to non-Hispanic whites, which researchers found not to be statistically significant.
Dr Sumpter added: “A combination of factors leads to higher rates of DKA among minority type 1 diabetes patients with COVID-19 that relate to social and structural risks. Social determinants of health, including income level, education, racial discrimination, and inadequate health care access, impact these populations with devastating complications for type 1 diabetes and COVID-19.”
Based on their findings, Dr Sumpter said interventions in these areas are essential to prevent poor outcomes that disparately impact minority populations.
The findings have been published in The Journal of Clinical Endocrinology & Metabolism.