Poster Session 1
Category: Diabetes
Poster Session 1
Melissa J. Cazzell, BS, MS
Medical Student
Eastern Virginia Medical School at Old Dominion University
Norfolk, Virginia, United States
Morgan A. Scaglione, MD
Maternal Fetal Medicine Fellow
Eastern Virginia Medical School at Old Dominion University
Norfolk, Virginia, United States
Erkan Kalafat, MD, MSc
Associate Professor
Koc University Hospital, Istanbul
Koc University Hospital, Istanbul, Istanbul, Turkey
Theresa Corbine, FNP
Eastern Virginia Medical School at Old Dominion University
Norfolk, Virginia, United States
George R. Saade, MD
Department of Obstetrics and Gynecology, Eastern Virginia Medical School at Old Dominion University
Norfolk, Virginia, United States
Grace Spencer, BS, MS
Eastern Virginia Medical School at Old Dominion University
EVMS OBGYN, Virginia Health Sciences at Old Dominion University, Virginia, United States
Marwan Ma'ayeh, MBBCH
Eastern Virginia Medical School at Old Dominion University
Norfolk, Virginia, United States
To evaluate whether higher levels of socioeconomic deprivation, as measured by the national Area Deprivation Index (ADI), are associated with increased severity of diabetic ketoacidosis (DKA) at presentation among pregnant individuals with pre-existing diabetes.
Study Design:
This was a retrospective cohort study of pregnant individuals with Type I or Type II diabetes mellitus. We identified all hospital admissions for DKA. The primary exposure was the national ADI, a composite measure of neighborhood socioeconomic disadvantage. The primary outcome was severe DKA, defined as meeting at least two of the following criteria on admission: serum bicarbonate < 10 mEq/L, anion gap >20 mEq/L, or blood glucose >350 mg/dL. We used multivariable mixed-effect logistic regression to evaluate the association between ADI and severe DKA, accounting for repeated admissions within the same pregnancy and adjusting for diabetes type, maternal age, and gestational age at admission.
Results:
A total of 158 DKA admissions from 107 unique pregnancies were included. As expected, patients with severe DKA had significantly lower admission bicarbonate (median 9.0 vs. 17.0 mEq/L, p< 0.001) and higher admission anion gap (median 25.0 vs. 18.9 mEq/L, p< 0.001) compared to the non-severe group (Table 1). There was no significant difference in the median national ADI between those presenting with severe DKA versus non-severe DKA (67.0.0 vs. 58.5, p=0.498). In the mixed-effect logistic regression analysis, there was no statistically significant association between a higher ADI and the odds of presenting with severe DKA for patients with either Type I (OR 1.31, p=0.886) or Type II diabetes (OR 1.11, p=0.977) (Table 2).
Conclusion:
In this cohort of pregnant individuals with pre-existing diabetes, neighborhood-level socioeconomic deprivation as measured by the national ADI was not associated with the clinical severity of DKA at presentation.