The effect of deprivation and HbA1c on admission to hospital for diabetic ketoacidosis in type 1 diabetes
Autor: | L, Govan, E, Maietti, B, Torsney, O, Wu, A, Briggs, H M, Colhoun, C M, Fischbacher, G P, Leese, J A, McKnight, A D, Morris, N, Sattar, S H, Wild, R S, Lindsay, J J, Walker |
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Rok vydání: | 2012 |
Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Pediatrics Diabetic ketoacidosis Endocrinology Diabetes and Metabolism Article Diabetic Ketoacidosis Young Adult Patient Admission Risk Factors Diabetes mellitus Internal Medicine medicine Humans Registries Young adult Intensive care medicine Glycated Hemoglobin Type 1 diabetes business.industry Data Collection Socioeconomic group Smoking Human physiology Middle Aged medicine.disease Diabetes Mellitus Type 1 Scotland Socioeconomic Factors Female business Complication Record linkage |
Zdroj: | Diabetologia. 55:2356-2360 |
ISSN: | 1432-0428 0012-186X |
DOI: | 10.1007/s00125-012-2601-6 |
Popis: | Diabetic ketoacidosis is a potentially life-threatening complication of diabetes and has a strong relationship with HbA(1c). We examined how socioeconomic group affects the likelihood of admission to hospital for diabetic ketoacidosis.The Scottish Care Information - Diabetes Collaboration (SCI-DC), a dynamic national register of all cases of diagnosed diabetes in Scotland, was linked to national data on hospital admissions. We identified 24,750 people with type 1 diabetes between January 2005 and December 2007. We assessed the relationship between HbA(1c) and quintiles of deprivation with hospital admissions for diabetic ketoacidosis in people with type 1 diabetes adjusting for patient characteristics.We identified 23,479 people with type 1 diabetes who had complete recording of covariates. Deprivation had a substantial effect on odds of admission to hospital for diabetic ketoacidosis (OR 4.51, 95% CI 3.73, 5.46 in the most deprived quintile compared with the least deprived). This effect persisted after the inclusion of HbA(1c) and other risk factors (OR 2.81, 95% CI 2.32, 3.39). Men had a reduced risk of admission to hospital for diabetic ketoacidosis (OR 0.71, 95% CI 0.63, 0.79) and those with a history of smoking had increased odds of admission to hospital for diabetic ketoacidosis by a factor of 1.55 (95% CI 1.36, 1.78).Women, smokers, those with high HbA(1c) and those living in more deprived areas have an increased risk of admission to hospital for diabetic ketoacidosis. The effect of deprivation was present even after inclusion of other risk factors. This work highlights that those in poorer areas of the community with high HbA(1c) represent a group who might be usefully supported to try to reduce hospital admissions. |
Databáze: | OpenAIRE |
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