Characteristics of ketosis-prone diabetes in a multiethnic indigent community

Ethn Dis. Spring 2004;14(2):243-9.

Abstract

Objective: To compare demographic and clinical characteristics among 3 ethnic groups of indigent patients exhibiting diabetic ketoacidosis (DKA), in Houston, Texas.

Methods: Over a span of 3.5 years, 321 patients were interviewed at the time of admission for DKA. Demographic, clinical, and biochemical data and measures of pancreatic beta-cell function were obtained at baseline and during follow up. Pearson's chi-square test, or one-way ANOVA, were used, as appropriate, to evaluate group differences.

Results: Of the 321 subjects, 44% were African-American, 40% were Hispanic, and 16% were Caucasian. A significantly higher proportion of Hispanics had preserved beta-cell function, compared to African Americans and Caucasians (51% vs 32% and 32%, respectively; P = .002). This difference, present at the time of the admission, was maintained through follow up. In a multivariate analysis, Hispanic ethnicity (OR 3.61; 95% CI 1.48-9.29) was a significant predictor of preserved beta-cell function. In addition, Hispanics were less likely to develop DKA as a result of treatment non-compliance, and more likely to have DKA precipitated by an acute illness.

Conclusions: Our findings indicated that ethnicity is associated with significant differences in the pathophysiologic and clinical characteristics of indigent, ketosis-prone patients. Hispanic ethnicity was found to be associated with greater beta-cell functional reserve, and less dependence on chronic insulin therapy.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • African Americans / statistics & numerical data*
  • Age Distribution
  • Analysis of Variance
  • Blood Glucose / analysis
  • Diabetic Ketoacidosis / ethnology*
  • Diabetic Ketoacidosis / etiology
  • Diabetic Ketoacidosis / physiopathology
  • European Continental Ancestry Group / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Health Status Indicators
  • Hispanic Americans / statistics & numerical data*
  • Humans
  • Interviews as Topic
  • Islets of Langerhans / physiopathology
  • Male
  • Medical Records
  • Middle Aged
  • Outpatient Clinics, Hospital
  • Patient Compliance / ethnology
  • Poverty / ethnology*
  • Texas / epidemiology

Substances

  • Blood Glucose