Children with type 1 diabetes are nearly five times as likely as their peers without the disease to be admitted to the hospital for any reason, researchers reported in BMJ Open, noting that the youngest children and those with low socioeconomic status appear to have the highest risk.
“The incidence of type 1 diabetes in childhood is increasing 3% to 4% per annum, more so in pre-school-aged, leading to increased demands on services,” they wrote. “The management of [type 1 diabetes] in childhood is demanding due to a complex treatment regimen. It is unsurprising that complications of suboptimal management, such as hypoglycemia and ketoacidosis occur, leading to hospitalization.”
In this study, researchers evaluated data from 577 Welsh children aged 0 to 15 years from the Brecon Group Register with newly diagnosed type 1 diabetes from 1999 to 2009 and 7,800 control patients, matched for age, sex, country and deprivation, who were randomly selected from the local population.
Specifically, they looked at differences in all-cause hospital admission rates, 30 days after diagnosis, until May 2012.
After 12,102 person-years of follow-up, the researchers found that risk for hospital admission was 480% higher (incidence rate ratios [IRR], 5.789; 95% CI, 5.34-6.723) among children with type 1 diabetes vs. matched controls.
Data indicated that highest absolute excess of admission was among children aged 5 years and younger. Hospital admissions decreased by 15.4% (IRR, 0.846; 95% CI, 0.744-0.965) with every 5-year increase in age at diagnosis, according to the data.
Socioeconomic status also appeared to be a factor, with results revealing a trend toward increasing admission rates among children with lower socioeconomic status. There was no evidence, however, of a differential rate of admissions between sexes when adjusted for background risk.
The researchers also observed a 16.1% (IRR, 0.839; 95% CI, 0.709-0.990) decrease in hospital admissions among those receiving outpatient care at large vs. small centers.
“Further study is required to identify how clinical care should be targeted to improve outcomes and reduce healthcare-related costs, particularly in young patients, those from disadvantaged socioeconomic backgrounds and those being cared for in similar centers,” the researchers wrote.
“This is an area of great clinical importance, as patients admitted to hospital with diabetes aged under 30 years have a death rate nine times that of the general population.”