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Hospitalization among diabetic children and adolescents and non-diabetic control subjects: a prospective
A Icks1, J Rosenbauer, B Haastert
1Department of Biometrics and Epidemiology, German Diabetes Research Institute, Düsseldorf University.
Insights
Children and adolescents with Type I diabetes have a 4.7 times higher risk of hospitalization and spend 7.7 times more days in the hospital during their first year post-diagnosis compared to non-diabetic peers.
Area of Science:
- Pediatric Endocrinology
- Public Health
- Epidemiology
Background:
- Limited data exists on hospitalization rates for pediatric patients with Type I diabetes compared to the general pediatric population.
- Understanding these disparities is crucial for resource allocation and healthcare planning.
Purpose of the Study:
- To compare hospitalization incidence and duration between newly diagnosed Type I diabetic children and adolescents and matched non-diabetic controls in Germany.
- To quantify the excess hospitalization risk and hospital days in the first year after diabetes onset.
Main Methods:
- Population-based incidence study involving 373 newly diagnosed diabetic children (<15 years) and 783 matched non-diabetic controls.
- Follow-up period averaged 1 year, with data collected via questionnaires on hospital admissions and length of stay.
- Poisson regression analysis was used to calculate hospitalization incidence rate ratios (IRRs) and days in hospital rate ratios (DRRs), adjusting for covariates.
Main Results:
- Diabetic children experienced significantly higher hospitalization rates (0.34 vs. 0.07 per person-year) and spent more days in hospital (2.36 vs. 0.29 per person-year) than controls.
- The hospitalization incidence rate ratio (IRR) was 4.7 (95% CI: 3.5-6.5), and the days in hospital rate ratio (DRR) was 7.7 (95% CI: 6.7-8.9).
- Higher age and female sex were associated with increased hospitalization parameters among diabetic subjects.
Conclusions:
- In the initial year post-diagnosis, pediatric patients with Type I diabetes face substantially elevated hospitalization risks and longer hospital stays compared to their non-diabetic counterparts.
- Observed ratios were lower than historical data from Nordic countries, suggesting potential influence of healthcare system differences and temporal trends.
- These findings highlight the significant healthcare burden associated with newly diagnosed Type I diabetes in children and adolescents.
Aim/Hypothesis:
Data comparing the hospitalization of diabetic paediatric patients with the non-diabetic population is scarce. We undertook a population-based incidence study to compare hospitalization in a cohort of Type I diabetic children and adolescents. in Germany, in the first course of treatment after diabetes onset, with hospitalization in non-diabetic control subjects matched for age, sex, and region.
Methods:
A total of 373 subjects with newly diagnosed diabetes (onset between 1 and under 15 (<15) years of age in 1996 and 1997; 54% male, mean age at diagnosis 7.6 +/- 3.8 years) and 783 non-diabetic control subjects matched for age, sex, and region were followed for 1 year on average. Hospital admissions and the length of stay (days) were assessed by written questionnaires. Incidence rates of hospitalization and the expected number of hospital days per person-year were estimated for both cohorts. Using Poisson regression, we estimated ratios of hospitalization incidence rates (IRRs) and of expected numbers of hospital days (DRRs) in the diabetic cohort compared to the non-diabetic cohort, adjusting for age, sex and social status.
Results:
Hospitalization incidence rates and hospital days, expressed per person-year (95%-CI). were 0.34 (0.29-0.39) and 2.36 (2.22-2.50) in the diabetic cohort and 0.07 (0.05-0.09) and 0.29 (0.26-0.33) in the non-diabetic cohort, respectively. Among diabetic subjects, both parameters were associated with higher age and female sex. IRR and DRR (95%-CI) were 4.7 (3.5-6.5) and 7.7 (6.7-8.9).
Conclusion/Interpretation:
In the first year after onset, children and adolescents with diabetes had a 4.7 times higher hospitalization risk and spent 7.7 times more days in hospital than non-diabetic subjects. The ratios were smaller than those in Finland and Denmark in the 1980s, most likely due to differences between health care systems and time trends.