Frequency of Ketoacidosis at Diagnosis of Pediatric Type 1 Diabetes Associated With Socioeconomic Deprivation and Urbanization: Results From the German Multicenter DPV Registry
Auzanneau M, Rosenbauer J, Warncke K, Maier W, Kamrath C, Hofmann T, Wurm M, Hammersen J, Schröder C, Hake K, Holl RW (2022)
Publication Type: Journal article
Publication year: 2022
Journal
Book Volume: 45
Pages Range: 1807-1813
Journal Issue: 8
DOI: 10.2337/dc21-2227
Abstract
OBJECTIVE: To investigate whether socioeconomic deprivation and urbanization are associated with the frequency of diabetic ketoacidosis (DKA) at diagnosis of pediatric type 1 diabetes. RESEARCH DESIGN AND METHODS: Children and adolescents aged ≤18 years, living in Germany, with newly diagnosed type 1 diabetes documented between 2016 and 2019 in the Diabetes Prospective Follow-up Registry (DPV; Diabetes-Patienten-Verlaufsdokumentation), were assigned to a quintile of regional socioeconomic deprivation (German Index of Socioeconomic Deprivation) and to a degree of urbanization (Eurostat) by using their residence postal code. With multiple logistic regression models, we investigated whether the frequency of DKA at diagnosis was associated with socioeconomic deprivation or urbanization and whether associations differed by age-group, sex, or migration status. RESULTS: In 10,598 children and adolescents with newly diagnosed type 1 diabetes, the frequency of DKA was lowest in the least deprived regions (Q1: 20.6% [95% CI 19.0-22.4], and increased with growing socioeconomic deprivation to 26.9% [25.0-28.8] in the most deprived regions [Q5]; P for trend <0.001). In rural areas, the frequency of DKA at diagnosis was significantly higher than in towns and suburbs (intermediate areas) or in cities (27.6% [95% CI 26.0-29.3] vs. 22.7% [21.4-24.0], P < 0.001, or vs. 24.3% [22.9-25.7], P = 0.007, respectively). The results did not significantly differ by age-group, sex, or migration background or after additional adjustment for socioeconomic deprivation or urbanization. CONCLUSIONS: This study provides evidence that prevention of DKA at diagnosis by means of awareness campaigns and screening for presymptomatic type 1 diabetes should particularly target socioeconomically disadvantaged regions and rural areas.
Involved external institutions
Deutsches Zentrum für Diabetesforschung e.V. (DZD)
Germany (DE)
Klinikum Hochsauerland
Germany (DE)
Justus-Liebig-Universität Gießen
Germany (DE)
Universitätsklinikum Regensburg
Germany (DE)
Universität Ulm
Germany (DE)
Technische Universität München (TUM)
Germany (DE)
Universität Greifswald
Germany (DE)
Germany (DE)
Klinikum Hochsauerland
Germany (DE)
Justus-Liebig-Universität Gießen
Germany (DE)
Universitätsklinikum Regensburg
Germany (DE)
Universität Ulm
Germany (DE)
Technische Universität München (TUM)
Germany (DE)
Universität Greifswald
Germany (DE)
How to cite
APA:
Auzanneau, M., Rosenbauer, J., Warncke, K., Maier, W., Kamrath, C., Hofmann, T.,... Holl, R.W. (2022). Frequency of Ketoacidosis at Diagnosis of Pediatric Type 1 Diabetes Associated With Socioeconomic Deprivation and Urbanization: Results From the German Multicenter DPV Registry. Diabetes Care, 45(8), 1807-1813. https://dx.doi.org/10.2337/dc21-2227
MLA:
Auzanneau, Marie, et al. "Frequency of Ketoacidosis at Diagnosis of Pediatric Type 1 Diabetes Associated With Socioeconomic Deprivation and Urbanization: Results From the German Multicenter DPV Registry." Diabetes Care 45.8 (2022): 1807-1813.
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