Characteristics of ketosis-prone diabetes in a multiethnic indigent community.
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.
Maldonado
Mario R
MR
Division of Endocrinology, Department of Medicine, Baylor College of Medicine Houston, Texas 77030, USA. mariom@bcm.tmc.edu
Otiniano
Max E
ME
Lee
Rebekah
R
Rodriguez
Lucille
L
Balasubramanyam
Ashok
A
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D017677:Age Distribution; D000704:Analysis of Variance; D001786:Blood Glucose / Q000032:analysis; D016883:Diabetic Ketoacidosis / Q000208:ethnology* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D007515:Islets of Langerhans / Q000503:physiopathology; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010349:Patient Compliance / Q000208:ethnology; D011203:Poverty / Q000208:ethnology*; D013781:Texas / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
D001786:Blood Glucose