Age and sex differences in diabetic ketoacidosis outcomes in type 1 diabetes: a national cohort study
Main finding · In-hospital mortality, ages 18-44Result — go to the resultAdjusted odds ratio 0.72 95% CI 0.60–0.86Authors' conclusion
Our study showed that age and sex were closely linked to acute complications and in-hospital death. Women had lower odds of AKI but higher odds of sepsis than men, with a survival advantage limited to young adults, and mortality rose during the COVID-19 years for both sexes, especially in young men.
Study context
- Population
- Adult hospitalizations with diabetic ketoacidosis (DKA) in patients with T1D, stratified into age groups 18–44, 45–64 and ≥65 years; National Inpatient Sample 2016–2021
- Exposure
- Female vs male sex, stratified by age group
- Outcome
- In-hospital mortality
Methodological detailsNational Inpatient Sample 2016–2021, multivariable logistic regression
- National Inpatient Sample 2016–2021
- Multivariable logistic regression
Main finding
In-hospital mortality, ages 18-44
Adjusted odds ratio
0.72
95% CI 0.60–0.86
Womenvs Men
aOR 0.72 (95% CI 0.60–0.86)
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
| Outcome | aOR | P value |
|---|---|---|
| AKI by age groupWomen vs Men · ages 18-44 | 0.56 | all p<0.05 |
| AKI by age groupWomen vs Men · ages 45-64 | 0.71 | all p<0.05 |
| AKI by age groupWomen vs Men · ages ≥65 | 0.79 | all p<0.05 |
| Sepsis by age groupWomen vs Men · ages 18-44 | 1.66 | all p<0.05 |
| Sepsis by age groupWomen vs Men · ages 45-64 | 1.31 | all p<0.05 |
| Sepsis by age groupWomen vs Men · ages ≥65 | 1.17 | all p<0.05 |
Mortality trends, prepandemic (2016-2019) and pandemic (2020-2021)
- Pandemic: sharp mortality increase across all age-sex groups; young men
- from 0.48% to 0.89%
- Prepandemic: mortality increasing in young men, decreasing in young women
Original publication
Age and sex differences in diabetic ketoacidosis outcomes in type 1 diabetes: a national cohort study. BMJ Open Diabetes Res Care. Published 16 February 2026. doi:10.
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