Impact of Psychiatric Disorders on the Risk of Diabetic Ketoacidosis in Adults with Type 1 Diabetes Mellitus: a Propensity Score Matching Case-control Study

Overview

Journal Endocrine

Date 2025 Jan 24

PMID 39853629

Authors

Victor Navas Moreno

Carolina Sager La Ganga

Maria Sara Tapia Sanchiz

Marta Lopez Ruano

Maria Del Carmen Martinez Otero

Elena Carrillo Lopez

Juan Jose Raposo Lopez

Selma Amar

Sara Gonzalez Castanar

Monica Marazuela

Jose Alfonso Arranz Martin

Fernando Sebastian-Valles

Affiliations

Soon will be listed here.

Abstract

Purpose: This study aims to evaluate the association between psychiatric disorders and diabetic ketoacidosis (DKA) in patients with type 1 diabetes (T1D) treated at a tertiary care hospital.

Methods: A propensity score-matched case-control study was conducted, comprising a total sample of 194 participants (97 DKA cases and 97 controls without DKA). Comprehensive data were collected on clinical, anthropometric, and socioeconomic characteristics, and psychiatric disorders were classified according to international standards.

Results: The mean age of the participants was 47.4 ± 17.7 years, with 55.6% being female. Psychiatric disorders were identified in 16.5% of the study population. The prevalence of psychiatric disorders was significantly higher in DKA cases compared to controls (24.7% vs. 7.2%, p < 0.001). Conditional logistic regression models revealed that the association between psychiatric disorders and DKA was not independent of HbA1c levels. Additionally, in HbA1c-stratified analyses, patients with psychiatric disorders developed DKA at lower HbA1c levels compared to controls.

Conclusion: Psychiatric disorders significantly increase the risk of DKA in adults with T1D, particularly among those with less elevated HbA1c levels. These findings highlight the critical importance of addresing psychiatric comorbidities in the management of T1D, given the severe implications and significant healthcare resource utilization associated with DKA.

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