Differences in Clinical Outcomes Between Non-Obese Caucasian and African American Populations Who Have Diabetes, A Nation-Wide Study

Abstract

DM is a metabolic disease that is closely linked with ethnicity. There is limited data on its outcomes in different racial groups. Controlling DM will mitigate the risks of atherosclerotic cardiovascular disease. The purpose of this study is to compare differences in clinical outcomes in non-obese Caucasian and African American (AA) populations with DM. Conducted as an observational study, it utilized data from the National Inpatient Sample from 2017 to 2020 focusing on non-obese adults over 18 years, with a BMI <30 kg/m^2, and DM diagnosis, excluding those under 18, obese or without DM. Primary outcome was in-hospital mortality. Secondary outcomes were cardiogenic shock, cardiac arrest, GIB, mechanical ventilation, length of stay, and total cost. Multivariable logistic and Poisson regression analyses determined the clinical outcomes, considering a p-value <0.05 significant. Among 22,300,000 non-obese adults with DM, 64.2% were Caucasians, 18.8% were AA, 13.3% were Hispanics, 3.5% were Asians, and the remaining population belonged to other ethnicities. This study revealed higher rates in the Caucasians for conditions like metabolic syndrome, dyslipidemia, HTN, A.fib, PVD, ACS, severe sepsis, and COPD. The AA were seen to have a higher incidence of anemia, DKA, pHTN, HF, AKI, CKD, stroke, and PE. In terms of the primary outcome, Caucasians had more in-hospital mortality than the AA, but the results were not statistically significant. Results for the secondary outcomes were variable as seen in Table 1. The findings undermine the importance of racial differences in such conditions and more in-depth studies are needed to extrapolate the gaps in care.