Researchers Find Racial Disparities in Type 1 Diabetes, COVID-19 Infection

Non-Hispanic Black patients with type 1 diabetes and COVID-19 were nearly 4 times as likely to go to the hospital with diabetic ketoacidosis (DKA) compared to non-Hispanic white patients, according to new research published in The Journal of Clinical Endocrinology & Metabolism.

Earlier 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 makes it critical to understand how COVID-19 and type 1 diabetes interact and affect outcomes, according to the study.

The new results show that non-Hispanic Black patients with COVID-19 and type 1 diabetes have an additional risk of DKA beyond the risk of having diabetes or being of minority status, according to a press release.

Study author Kathryn Sumpter, MD, a pediatric endocrinology at Le Bonheur, examined 180 patients with type 1 diabetes and laboratory-confirmed COVID-19. The patients came from 52 clinical sites, including Le Bonheur Children’s Hospital. Sumpter aimed to evaluate instances of DKA in these patients to determine whether minorities had an increased risk when controlled for sex, age, insurance, and last hemoglobin A1c (HbA1c) level.

“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,” Sumpter said in the press release. “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 patients were 55% more likely to present with DKA and COVID-19 compared to non-Hispanic whites, who were 13% more likely. Hispanics had almost 2 times greater odds of presenting with DKA compared to non-Hispanic whites, which researchers found not to be statistically significant.

“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,” Sumpter said in the release. “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, Sumpter said interventions in these areas are essential to prevent poor outcomes that disparately impact minority populations.

REFERENCE

Health Disparities in Type 1 Diabetes and COVID-19 Infection Research by Dr. Kathryn Sumpter [news release]. Le Bonheur; March 17, 2021. https://www.lebonheur.org/news/health-disparities-in-type-1-diabetes-and-covid-19-infection-research-by-dr-kathryn-sumpter. Accessed March 23, 2021.