Hospitalizations for diabetes increase, especially among younger women

The number of hospitalizations with a primary or secondary diagnosis of diabetes increased dramatically between 1993 and 2006, especially among younger people, a new study found.

Researchers gathered their statistics from hospital discharges included in the Nationwide Inpatient Sample and the results were published online by the Journal of Women's Health. Over the 14-year period, diabetes hospitalizations increased 65.3% overall. The largest increase in discharges of 102% was among patients 30-39 years old. Younger women saw greater increases than younger men, with diabetes hospitalizations increasing 63% in 20- to 29-year-old women and 118% in 30- to 39-year-olds (compared to 46% and 85% respectively in men). At age 50, the trend flipped, with more men over age 50 being hospitalized for diabetes than women. During this same time period, overall hospitalization rates for adults declined, the study authors noted.

The analysis also looked at the primary diagnoses associated with these hospitalizations. Excluding pregnancy-related hospitalizations, diabetes with complications was the top diagnosis in all age groups, but psychiatric disorders also accounted for a substantial proportion of younger patients' hospitalizations. Affective disorders were the second most common diagnosis in women 20-39, while schizophrenia was the fifth biggest among young men. Younger age and female gender have been associated with increased risk of depression in diabetics, and atypical neuroleptics have been associated with incident diabetes, the study authors noted.

Overall, the increases found by the study may reflect increasing diabetes prevalence in the adult population, the authors said. The differences between men and women may be related to previous findings that women diabetics receive less preventive care and aggressive medical management. However, the study was limited by several potential confounding factors, including increasing awareness of type 2 diabetes during the time period (which could lead to more diagnoses recorded in hospital records) and the change in 1997 to defining diabetes as a fasting blood glucose of 126 mg/dL or higher, instead of 140 mg/dL or higher.

Still, the statistics indicate that the cost burden of diabetes hospitalizations will continue to escalate as these patients age, the authors concluded. They recommended more focus on diabetes prevention and research to assess whether the growth in hospitalizations has resulted from increasing prevalence of diabetes or an increasing burden of comorbid disease.