Introduction and Objective: DKA at the time of first presentation of T1DM is preventable. The aim of this study was to determine the proportion of individuals with a new onset T1DM, by race and ethnicity, presenting with DKA in a large integrated healthcare system based in Northern California (Sutter Health).Methods: ICD-9 and ICD-10 codes were used to identify adults and children with DKA one month either side of a new diagnosis of T1DM, between January 2016 and September 2024. T1DM cases were identified using prescription for insulin and relevant codes in the electronic health record problem list, or billing data. Testing for the difference in proportion of T1DM patients with DKA were made using the Pearson Chi-Square test.Results: Of 10,956 new T1DM patients, 699 (6.4%) had a co-diagnosis of DKA within one month of a first diagnosis of T1DM. Rates of T1DM presenting with DKA were different by race/ethnicity (p<0.0001) comparing White (5.9%) vs Hispanic (7.8%), Black (10.2%), and Asian (6.6%) patients. Across age groups, the rate of DKA within one month of a first diagnosis of T1DM was highest among those aged 18-25 years (p<0.0001).Conclusion: The risk of DKA at the first presentation of T1DM varies by race and ethnicity. As DKA is preventable, greater efforts are required to reduce this disproportionate risk especially for communities of color.
S. Mudiganti: None. P. Kenkare: None. D. Kerr: None.
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