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Markedly increased incidence of critical illness in adults with Type 1 diabetes

R A Marrie1,2, E A C Sellers3,4, H Chen5

  • 1Department of Internal Medicine, University of Manitoba, Winnipeg, Canada.

Diabetic Medicine : a Journal of the British Diabetic Association
|June 20, 2017
PubMed

Insights

Adults with paediatric-onset Type 1 diabetes have an eightfold higher risk of intensive care unit admission. Mortality after intensive care unit admission is also significantly higher in this population compared to the general population.

Area of Science:

  • Endocrinology
  • Critical Care Medicine
  • Epidemiology

Background:

  • Type 1 diabetes (T1D) is a chronic autoimmune condition requiring lifelong management.
  • Paediatric-onset T1D represents a significant burden of disease from a young age.
  • Understanding long-term outcomes in the intensive care unit (ICU) for this population is crucial.

Purpose of the Study:

  • To compare the incidence of intensive care unit (ICU) admission in adults with paediatric-onset Type 1 diabetes versus the general population.
  • To compare mortality rates following ICU admission between these two groups.

Main Methods:

  • Population-based administrative data from Manitoba, Canada, were used.
  • 814 cases of paediatric-onset T1D and 3579 matched general population controls were identified.
  • Incidence rate ratios and Cox proportional hazards regression were employed to compare ICU admission risks and mortality.

Main Results:

  • The incidence of ICU admission was 910 per 100,000 in the T1D cohort versus 106 per 100,000 in controls (incidence rate ratio 8.6).
  • Women with T1D had a substantially higher adjusted risk of ICU admission (hazard ratio 14.7) than men with T1D (hazard ratio 4.92).
  • Common reasons for ICU admission included diabetic ketoacidosis, infection, and ischemic heart disease. Five-year mortality was 5.7 times higher in the T1D cohort.

Conclusions:

  • Adults with paediatric-onset Type 1 diabetes face a significantly elevated risk of ICU admission compared to the general population.
  • Mortality following ICU admission is also markedly higher for individuals with T1D.
  • This highlights the need for vigilant monitoring and management of T1D to prevent severe complications and improve critical care outcomes.
Abstract

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