{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T07:49:37Z","timestamp":1791618577430,"version":"4.3.4"},"reference-count":16,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:00:00Z","timestamp":1791590400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:00:00Z","timestamp":1791590400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR303671"],"award-info":[{"award-number":["NIHR303671"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although ethnic disparities in diabetes prevalence and chronic complications are well recognised, their association with acute metabolic emergencies and outcomes is not well established. In this study, we investigated the association between ethnicity and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective multicentre study included adults (\u226516\u2009years) admitted with diabetic ketoacidosis (DKA), hyperosmolar hyperglycaemic state (HHS) and hypoglycaemia between 2020 and 2023 in participating centres of the Digital Evaluation of Ketosis and Other Diabetes Emergencies (DEKODE) surveillance programme. Ethnicity was grouped as White, Asian or Black. Multivariable linear and logistic regression models assessed associations between ethnicity and length of stay (LOS), episode duration and in\u2010hospital mortality, adjusting for demographic, biochemical and clinical covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 6859 episodes were analysed (4257 DKA; 191 HHS; 2411 hypoglycaemia). Across these, differences were observed in age at presentation, metabolic parameters,\u00a0and LOS across ethnic groups. In DKA, Black and Asian ethnicities were associated with longer LOS than White ethnicity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Black ethnicity was also associated with prolonged DKA duration (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006). In the HHS cohort, Asian ethnicity was associated with longer LOS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014) but lower in\u2010hospital mortality (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). In the hypoglycaemia cohort, Black ethnicity was associated with lower mortality (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Ethnic variation was observed in the presentation and outcomes of diabetic emergencies. After adjustment for demographic and clinical factors, ethnicity remained associated with several outcomes. These findings support further investigation into social, healthcare and pre\u2010hospital factors that may contribute to observed differences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.70488","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T07:30:08Z","timestamp":1791617408000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ethnicity is associated with variation in diabetes emergency outcomes: Findings from the\n                    <scp>DEKODE<\/scp>\n                    audit and feedback programme"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3420-1420","authenticated-orcid":false,"given":"Aspasia","family":"Manta","sequence":"first","affiliation":[{"name":"Department of Applied Health Sciences, School of Health Sciences, College of Medicine and Health University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4006-6954","authenticated-orcid":false,"given":"Aqeelah","family":"Khatoon","sequence":"additional","affiliation":[{"name":"Good Hope Hospital University Hospitals Birmingham NHS Foundation Trust  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1816-2909","authenticated-orcid":false,"given":"Kalyaani","family":"Persad","sequence":"additional","affiliation":[{"name":"Department of Applied Health Sciences, School of Health Sciences, College of Medicine and Health University of Birmingham  Birmingham UK"},{"name":"Midlands Metropolitan University Hospital Sandwell and West Birmingham Hospitals NHS Trust  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5682-5026","authenticated-orcid":false,"given":"Nevil C.","family":"Philip","sequence":"additional","affiliation":[{"name":"Department of Applied Health Sciences, School of Health Sciences, College of Medicine and Health University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0954-6512","authenticated-orcid":false,"given":"Punith","family":"Kempegowda","sequence":"additional","affiliation":[{"name":"Department of Applied Health Sciences, School of Health Sciences, College of Medicine and Health University of Birmingham  Birmingham UK"},{"name":"Department of Diabetes and Endocrinology, Queen Elizabeth Hospital Birmingham University Hospitals Birmingham NHS Foundation Trust  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"DEVI 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ChowdhuryA ForouhiN WarehamN MRC Epidemiology Unit UoC.Ethnic disparities in the major causes of mortality and their risk factors \u2013 a rapid review.2021.https:\/\/www.gov.uk\/government\/publications\/the\u2010report\u2010of\u2010the\u2010commission\u2010on\u2010race\u2010and\u2010ethnic\u2010disparities\u2010supporting\u2010research\/ethnic\u2010disparities\u2010in\u2010the\u2010major\u2010causes\u2010of\u2010mortality\u2010and\u2010their\u2010risk\u2010factors\u2010by\u2010dr\u2010raghib\u2010ali\u2010et\u2010al"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13828"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.10.2306"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-025-06513-4"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiz214"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare13222910"}],"container-title":["Diabetic 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