It’s not especially unusual for people with type 1 diabetes to be readmitted to a hospital within 30 days in cases of diabetic ketoacidosis, and people who are readmitted tend to experience worse outcomes, according to a new study presented at the Endocrine Society’s annual meeting, ENDO 2021, held virtually this year. The study was summarized in an article at MedPage Today.
Researchers looked at records of 91,625 hospitalizations for diabetic ketoacidosis — a serious complication of high blood glucose in which chemicals called ketones reach dangerous levels in the blood — in adults with type 1 diabetes. They found that 20.2% of these adults were readmitted to the hospital again within 30 days, and that those who were readmitted in this time period were 2.06 times as likely to die during their rehospitalization than during a hospitalization that wasn’t the second one within a 30-day period.
On average, patients’ second hospital stay was about one day longer than their initial stay for diabetic ketoacidosis. Not surprisingly, this translated into higher costs, with the second hospital stay costing an average of $8,217 more than the previous one. This number refers to total healthcare expenditures, not what a patient has to pay out of pocket or what their health insurance covers.
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Factors predicting second hospitalization
A number of factors predicted a second hospitalization within 30 days, including being female (14% more likely to be readmitted), having hypertension (high blood pressure; 28% more likely to be readmitted), having chronic kidney disease (13% more likely to be readmitted), having anemia (inadequate red blood cells; 42% more likely to be readmitted), and previously being discharged against medical advice (54% more likely to be readmitted). Somewhat surprisingly, having certain medical conditions in addition to type 1 made readmission less likely, including hyperlipidemia (high blood cholesterol or triglycerides; 8% less likely to be readmitted) and obesity (30% less likely to be readmitted).
One of the researchers explained that the lower readmission rate seen in people with obesity may be explained by the fact that taking insulin often results in weight gain, so being obese may be the result, in part, of taking as much insulin as a person needs to effectively control blood glucose levels. The link between higher blood cholesterol and triglycerides and a lower readmission risk may also be related to obesity, since these conditions are often seen in people who are overweight or obese.
The researchers noted that more studies are needed to look at all of the factors that may contribute to rehospitalization for diabetic ketoacidosis, including what kinds of education or other procedures may help when a person is discharged from the hospital.
Want to learn more about diabetic ketoacidosis? Read “DKA: What to Know and How to Deal.”