Socioeconomic determinants of recurrent DKA in US children.
Nadir Al-Saidi, Zainab Fatima, Ali S Esseili et al.
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In 30 seconds
This systematic review examined U.S. observational studies linking socioeconomic factors with recurrent diabetic ketoacidosis (DKA) in children. Sixteen studies were included, with findings synthesized descriptively and study quality assessed using the Newcastle-Ottawa Scale. Lower household income and public insurance were associated with higher recurrence; neighborhood disadvantage or low opportunity was associated with increased odds. Black race, lower parental education, homelessness, and limited access to technology were also consistently linked to recurrence. The abstract does not report a pooled effect estimate or a single quantitative measure of the strength of these associations.
Key findings
- Sixteen observational studies were included in the systematic review.
- Lower household income and public insurance were associated with higher recurrent DKA rates.
- Residence in neighborhoods with high disadvantage or low opportunity was associated with increased odds of recurrence.
- Black race, lower parental education, homelessness, and limited technology access were consistently associated with higher recurrence.
Why it matters
The findings indicate that recurrent DKA in U.S. children is associated with socioeconomic conditions at household, neighborhood, patient, and systemic levels. Recognizing these patterns can help frame recurrence as a concern linked not only to individual diabetes care but also to social and structural circumstances, while the review does not quantify the relative contribution of each factor.
What to keep in mind
The review included observational studies and synthesized results descriptively; the abstract provides no pooled effect estimate.