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.