Related Experiment Videos
Risk factors for hospitalization in people with diabetes
1Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison 53705-2397, USA. moss@epi.ophth.wisc.edu
Insights
Poor glycemic control and hypertension increase hospitalization risk in people with diabetes. Improving blood sugar management may reduce hospitalizations and healthcare costs for diabetic patients.
Area of Science:
- Endocrinology
- Public Health
- Clinical Medicine
Background:
- Diabetes mellitus is a chronic condition requiring ongoing management.
- Hospitalization represents a significant burden on healthcare systems and patients with diabetes.
- Predicting and preventing diabetes-related hospitalizations is crucial for improving patient outcomes and reducing costs.
Purpose of the Study:
- To identify key factors that predict hospitalization in individuals with diabetes.
- To differentiate predictive factors between younger-onset and older-onset diabetes groups.
- To inform strategies for reducing diabetes-related hospital admissions.
Main Methods:
- Longitudinal study of two population-based diabetes cohorts: younger-onset (insulin-dependent, diagnosed before 30) and older-onset (diagnosed after 30).
- Data collected at baseline, 4 years, and 10 years, including clinical measurements and self-reported hospitalization in the preceding year.
- Logistic regression models used to assess predictors of hospitalization at the 10-year mark based on 4-year data.
Main Results:
- In the younger-onset group, elevated glycosylated hemoglobin (HbA1c) and hypertension were significant predictors of hospitalization.
- In the older-onset group, only elevated glycosylated hemoglobin (HbA1c) significantly predicted hospitalization.
- Factors such as age, sex, blood pressure, body mass, smoking, and alcohol consumption did not predict hospitalization in either group.
Conclusions:
- Glycemic control, indicated by glycosylated hemoglobin levels, is a modifiable factor that significantly predicts hospitalization in people with diabetes.
- Interventions aimed at improving glycemic control hold potential for reducing hospitalizations and associated healthcare expenditures.
- Hypertension is an additional risk factor for hospitalization, particularly in younger-onset diabetes.
Objective:
To determine factors predicting hospitalization in people with diabetes.
Methods:
Two population-based groups with diabetes were examined at baseline (1980-1982), 4 years (1984-1986), and 10 years (1990-1992). The younger-onset group (n = 777) consisted of all persons diagnosed as having diabetes before age 30 years who were taking insulin, and the older-onset group (n = 542) consisted of a sample of persons diagnosed after age 30 years. At the 10-year examination, participants were asked if they had been hospitalized in the previous year. Factors from the 4-year examination were examined for their ability to predict hospitalization at the 10-year examination.
Results:
In the younger-onset group, 25.5% reported being hospitalized. In logistic models, glycosylated hemoglobin level (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.16-1.39 for a 1% increment) and hypertension (OR, 1.60; 95% CI, 1.08-2.38) predicted hospitalization. Factors that were not significant included age, sex, systolic and diastolic blood pressures, body mass, smoking status, and alcohol consumption. In the older-onset group, 30.8% reported being hospitalized. In logistic models, only glycosylated hemoglobin level (OR, 1.16; 95% CI, 1.06-1.29 for a 1% increment) predicted hospitalization.
Conclusions:
Glycemic control is subject to intervention. Better control may decrease hospitalization among people with diabetes. Thus, there is considerable potential for reducing health care costs.