Outpatient insulin use in type 2 diabetes mellitus and acute respiratory distress syndrome outcomes: A retrospective cohort study

doi:10.12998/wjcc.v12.i17.2966

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World Journal of Clinical Cases

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

World J Clin Cases. Jun 16, 2024; 12(17): 2966-2975
Published online Jun 16, 2024. doi: 10.12998/wjcc.v12.i17.2966

Table 1 Baseline characteristics of type 2 diabetes mellitus patients diagnosed with acute respiratory distress syndrome stratified into insulin-dependent and non-insulin-dependent groups (pre-match), n (%)

Characteristic	IDDM group, n = 274	NIDDM group, n = 900	P value
Age in yr	61.9 ± 13.3	63.5 ± 13.7	0.731
Female sex	134 (48.9)	436 (48.4)	0.894
Emergent	256 (93.4)	833 (92.7)	0.664
White	167 (60.9)	580 (64.4)	0.292
Black	54 (19.7)	125 (13.9)	0.019^a
Hispanic	34 (12.4)	116 (12.9)	0.835
Income interval in USD
< 46000	106 (38.7)	329 (36.6)	0.523
46000-58999	81 (29.6)	241 (26.8)	0.366
59000-78999	47 (17.2)	207 (23.0)	0.040^a
≥ 79000	40 (14.6)	123 (13.7)	0.696
Active smoking	45 (16.4)	143 (15.9)	0.833
COPD	68 (24.8)	253 (28.1)	0.284
CAD	78 (28.5)	217 (24.1)	0.146
CHF	128 (46.7)	406 (45.1)	0.641
CKD	78 (28.5)	247 (27.4)	0.740
HTN	195 (71.2)	608 (67.6)	0.005^a
pHTN	29 (10.6)	76 (8.4)	0.277
CLD	30 (10.9)	116 (12.9)	0.394
ESRD	41 (15)	111 (12.3)	0.256
Asthma	20 (7.3)	56 (6.2)	0.526
Obesity	99 (36.1)	273 (30.3)	0.071
DLD	136 (49.6)	349 (38.8)	0.001^a
AUD	10 (3.6)	54 (6.0)	0.134

^aP < 0.05.

AUD: Alcohol use disorder; CAD: Coronary artery disease; CKD: Chronic kidney disease; CHF: Congestive heart failure; CLD: Chronic liver disease; COPD: Chronic obstructive pulmonary disease; DLD: Dyslipidemia; ESRD: End-stage renal disease; HTN: Hypertension; IDDM: Insulin-dependent type 2 diabetes mellitus; NIDDM: Non-insulin-dependent type 2 diabetes mellitus; pHTN: Pulmonary hypertension; USD: United States dollars.

Table 2 Etiologies of acute respiratory distress syndrome before propensity score matching, n (%)

Etiology	IDDM group, n = 274	NIDDM group, n = 900	P value
Sepsis	160 (58.4)	605 (67.2)	0.007^a
Transfusion	0 (0.0)	5 (0.6)	0.216
Pancreatitis	7 (2.6)	31 (3.4)	0.466
Surgery	2 (0.7)	20 (2.2)	0.111
Pneumonia	163 (59.5)	479 (53.2)	0.068^a
Aspiration	55 (20.1)	220 (24.4)	0.135

^aP < 0.05.

IDDM: Insulin-dependent type 2 diabetes mellitus; NIDDM: Non-insulin-dependent type 2 diabetes mellitus.

Table 3 Baseline characteristics of type 2 diabetes mellitus patients diagnosed with acute respiratory distress syndrome stratified into insulin-dependent and non-insulin-dependent groups (post-match), n (%)

Characteristic	IDDM group^a, n = 274	NIDDM group^a, n = 274	P value
Age in yr	61.9 ± 13.3	61.2 ± 15.1	0.117
Female sex	134 (48.9)	143 (52.2)	0.442
Emergent	256 (93.4)	253 (92.3)	0.618
White	167 (60.9)	163 (59.5)	0.727
Black	54 (19.7)	55 (20.1)	0.915
Hispanic	34 (12.4)	35 (12.8)	0.898
Income interval in USD
< 46000	106 (38.7)	109 (39.8)	0.793
46000-58999	81 (29.6)	79 (28.8)	0.851
59000-78999	47 (17.2)	39 (14.2)	0.347
≥ 79000	40 (14.6)	47 (17.2)	0.413
Active smoking	45 (16.4)	47 (17.2)	0.819
COPD	68 (24.8)	67 (24.5)	0.921
CAD	78 (28.5)	67 (24.5)	0.287
CHF	128 (46.7)	116 (42.3)	0.302
CKD	78 (28.5)	73 (26.6)	0.633
HTN	195 (71.2)	194 (70.8)	0.925
pHTN	29 (10.6)	25 (9.1)	0.566
CLD	30 (10.9)	36 (13.1)	0.431
ESRD	41 (15)	36 (13.1)	0.539
Asthma	20 (7.3)	28 (10.2)	0.227
Obesity	99 (36.1)	110 (40.1)	0.333
DLD	136 (49.6)	141 (51.5)	0.669
AUD	10 (3.6)	15 (5.5)	0.306

^aP < 0.05.

Table 4 Etiologies of acute respiratory distress syndrome after propensity score matching, n (%)

Etiology	IDDM group, n = 274	NIDDM group, n = 274	P value
Sepsis	160 (58.4)	169 (61.7)	0.433
Transfusion	0 (0.0)	0 (0.0)	N/A
Pancreatitis	7 (2.6)	8 (2.9)	0.793
Surgery	2(0.7)	3 (1.1)	0.653
Pneumonia	163 (59.5)	161 (58.8)	0.862
Aspiration	55 (20.1)	50 (18.2)	0.587

IDDM: Insulin-dependent type 2 diabetes mellitus; N/A: Not applicable; NIDDM: Non-insulin-dependent type 2 diabetes mellitus.

Table 5 Primary outcomes of acute respiratory distress syndrome assessed post-propensity score matching, n (%)

Outcome	IDDM group, n = 274	NIDDM group, n = 274	P value
AKI	140 (51.1)	146 (53.3)	0.600
Duration of mechanical ventilation in h
< 24	39 (14.2)	36 (13.1)	0.709
24-96	42 (15.3)	49 (17.9)	0.422
> 96	101 (36.9)	109 (39.8)	0.482
Mortality	90 (32.8)	85 (31.0)	0.520
Patient's disposition
Home	53 (19.3)	49 (17.9)	0.661
Home health care	28 (10.2)	28 (10.2)	0.999
Skilled nursing facility	103 (37.6)	112 (40.9)	0.431
Length of stay	10 (5-19)	10 (5-17)	0.537
Total charges in USD	130466 (59830-268939)	134033 (53771-272176)	0.060

AKI: Acute kidney injury; IDDM: Insulin-dependent type 2 diabetes mellitus; NIDDM: Non-insulin-dependent type 2 diabetes mellitus; USD: United States dollars.

Citation: Khattar G, Asmar S, Aoun L, Saliba F, Almardini S, Abu Baker S, Hong C, El Chamieh C, Haddadin F, Habib T, Mourad O, Morcos Z, Arafa F, Mina J, El Gharib K, Aldalahmeh M, Khan S, Bou Sanayeh E. Outpatient insulin use in type 2 diabetes mellitus and acute respiratory distress syndrome outcomes: A retrospective cohort study. World J Clin Cases 2024; 12(17): 2966-2975
URL: https://www.wjgnet.com/2307-8960/full/v12/i17/2966.htm
DOI: https://dx.doi.org/10.12998/wjcc.v12.i17.2966