Background: Obesity is associated with better outcomes in diseases like myocardial infarction and heart failure, a phenomenon known as obesity paradox. However, the effect of obesity on healthcare outcomes after admission for diabetic ketoacidosis (DKA) has not been well characterized.

Objective: We aimed to explore the impact of obesity and morbid obesity on outcomes in patients hospitalized with DKA.

Methods: The National Inpatient Sample database for the year 2016 was queried. All admissions with a principal diagnosis of DKA were identified. Obesity (BMI 30-40 kg/m2) and morbid obesity (BMI >40 Kg/m2) were identified using their appropriate validated ICD-10 codes. Statistical analysis was performed using STATA. The Odds ratio adjusted for age and gender was calculated for obesity and morbid obesity respectively.

Results: The study included 210,455 hospitalizations with a principal diagnosis of DKA. Out of these, 19,341 (9.19%) were obese and 7,640 (3.63%) were morbidly obese. Obese DKA patients had a longer length of stay (3.79 vs. 3.14 days, p<0.001) and higher hospitalization costs ($34,643 vs. $28,976; p<0.001) compared to their non-obese counterparts. There was no significant difference in the adjusted in-hospital mortality rates in DKA patients with and without obesity (0.52% vs. 0.38%, adjusted odds ratio 1.25, p=0.34). However, DKA patients who were morbidly obese had increased mortality compared to those without morbid obesity (0.72% vs. 0.38%, adjusted odds ratio 1.85, p=0.04).

Conclusion: DKA patients with obesity have a longer length of stay and higher hospitalization costs, but similar inpatient mortality rates compared to those without obesity. Morbid obesity is associated with increased mortality in DKA patients.


M. Mudgal: None. A. Goel: None.

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