Trends in diabetic ketoacidosis‐ and hyperosmolar hyperglycemic state‐related mortality during theCOVID‐19 pandemic in the United States: A population‐based study

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Auteurs principaux: Xinyuan He, Amy Huaishiuan Huang, Fan Lv, Xu Gao, Yuxin Guo, Yishan Liu, Xiaoqin Hu, Jingyi Xie, Ning Gao, Yang Jiao, Yuan Wang, Jian Zu, Lei Zhang, Fanpu Ji, Yee Hui Yeo
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author Xinyuan He
Amy Huaishiuan Huang
Fan Lv
Xu Gao
Yuxin Guo
Yishan Liu
Xiaoqin Hu
Jingyi Xie
Ning Gao
Yang Jiao
Yuan Wang
Jian Zu
Lei Zhang
Fanpu Ji
Yee Hui Yeo
author_facet Xinyuan He
Amy Huaishiuan Huang
Fan Lv
Xu Gao
Yuxin Guo
Yishan Liu
Xiaoqin Hu
Jingyi Xie
Ning Gao
Yang Jiao
Yuan Wang
Jian Zu
Lei Zhang
Fanpu Ji
Yee Hui Yeo
Xinyuan He
Amy Huaishiuan Huang
Fan Lv
Xu Gao
Yuxin Guo
Yishan Liu
Xiaoqin Hu
Jingyi Xie
Ning Gao
Yang Jiao
Yuan Wang
Jian Zu
Lei Zhang
Fanpu Ji
Yee Hui Yeo
collection Wiley Open Access
contents Trends in diabetic ketoacidosis‐ and hyperosmolar hyperglycemic state‐related mortality during theCOVID‐19 pandemic in the United States: A population‐based study Xinyuan He Amy Huaishiuan Huang Fan Lv Xu Gao Yuxin Guo Yishan Liu Xiaoqin Hu Jingyi Xie Ning Gao Yang Jiao Yuan Wang Jian Zu Lei Zhang Fanpu Ji Yee Hui Yeo Journal of Diabetes AbstractBackgroundDuring the pandemic, a notable increase in diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS), conditions that warrant emergent management, was reported. We aimed to investigate the trend of DKA‐ and HHS‐related mortality and excess deaths during the pandemic.MethodsAnnual age‐standardized mortality rates related to DKA and HHS between 2006 and 2021 were estimated using a nationwide database. Forecast analyses based on prepandemic data were conducted to predict the mortality rates during the pandemic. Excess mortality rates were calculated by comparing the observed versus predicted mortality rates. Subgroup analyses of demographic factors were performed.ResultsThere were 71 575 DKA‐related deaths and 8618 HHS‐related deaths documented during 2006–2021. DKA, which showed a steady increase before the pandemic, demonstrated a pronounced excess mortality during the pandemic (36.91% in 2020 and 46.58% in 2021) with an annual percentage change (APC) of 29.4% (95% CI: 16.0%–44.0%). Although HHS incurred a downward trend during 2006–2019, the excess deaths in 2020 (40.60%) and 2021 (56.64%) were profound. Pediatric decedents exhibited the highest excess mortality. More than half of the excess deaths due to DKA were coronavirus disease 2019 (COVID‐19) related (51.3% in 2020 and 63.4% in 2021), whereas only less than a quarter of excess deaths due to HHS were COVID‐19 related. A widened racial/ethnic disparity was observed, and females exhibited higher excess mortality than males.ConclusionsThe DKA‐ and HHS‐related excess mortality during the pandemic and relevant disparities emphasize the urgent need for targeted strategies to mitigate the escalated risk in these populations during public health crises.image 10.1111/1753-0407.13591 http://creativecommons.org/licenses/by/4.0/
doi_str_mv 10.1111/1753-0407.13591
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institution Wiley Open Access
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publishDate 2024
publisher Wiley
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spellingShingle Trends in diabetic ketoacidosis‐ and hyperosmolar hyperglycemic state‐related mortality during theCOVID‐19 pandemic in the United States: A population‐based study
Xinyuan He
Amy Huaishiuan Huang
Fan Lv
Xu Gao
Yuxin Guo
Yishan Liu
Xiaoqin Hu
Jingyi Xie
Ning Gao
Yang Jiao
Yuan Wang
Jian Zu
Lei Zhang
Fanpu Ji
Yee Hui Yeo
Journal of Diabetes
Trends in diabetic ketoacidosis‐ and hyperosmolar hyperglycemic state‐related mortality during theCOVID‐19 pandemic in the United States: A population‐based study Xinyuan He Amy Huaishiuan Huang Fan Lv Xu Gao Yuxin Guo Yishan Liu Xiaoqin Hu Jingyi Xie Ning Gao Yang Jiao Yuan Wang Jian Zu Lei Zhang Fanpu Ji Yee Hui Yeo Journal of Diabetes AbstractBackgroundDuring the pandemic, a notable increase in diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS), conditions that warrant emergent management, was reported. We aimed to investigate the trend of DKA‐ and HHS‐related mortality and excess deaths during the pandemic.MethodsAnnual age‐standardized mortality rates related to DKA and HHS between 2006 and 2021 were estimated using a nationwide database. Forecast analyses based on prepandemic data were conducted to predict the mortality rates during the pandemic. Excess mortality rates were calculated by comparing the observed versus predicted mortality rates. Subgroup analyses of demographic factors were performed.ResultsThere were 71 575 DKA‐related deaths and 8618 HHS‐related deaths documented during 2006–2021. DKA, which showed a steady increase before the pandemic, demonstrated a pronounced excess mortality during the pandemic (36.91% in 2020 and 46.58% in 2021) with an annual percentage change (APC) of 29.4% (95% CI: 16.0%–44.0%). Although HHS incurred a downward trend during 2006–2019, the excess deaths in 2020 (40.60%) and 2021 (56.64%) were profound. Pediatric decedents exhibited the highest excess mortality. More than half of the excess deaths due to DKA were coronavirus disease 2019 (COVID‐19) related (51.3% in 2020 and 63.4% in 2021), whereas only less than a quarter of excess deaths due to HHS were COVID‐19 related. A widened racial/ethnic disparity was observed, and females exhibited higher excess mortality than males.ConclusionsThe DKA‐ and HHS‐related excess mortality during the pandemic and relevant disparities emphasize the urgent need for targeted strategies to mitigate the escalated risk in these populations during public health crises.image 10.1111/1753-0407.13591 http://creativecommons.org/licenses/by/4.0/
title Trends in diabetic ketoacidosis‐ and hyperosmolar hyperglycemic state‐related mortality during theCOVID‐19 pandemic in the United States: A population‐based study
topic Journal of Diabetes
url https://onlinelibrary.wiley.com/doi/10.1111/1753-0407.13591