Diabetes and Prediabetes and Risk of Hospitalization: The Atherosclerosis Risk in Communities (ARIC) Study

Abstract

OBJECTIVETo examine the magnitude and types of hospitalizations among persons with prediabetes, undiagnosed diabetes, and diagnosed diabetes.RESEARCH DESIGN AND METHODSThis study included 13,522 participants in the Atherosclerosis Risk in Communities (ARIC) study (mean age 57 years, 56% female, 24% black, 18% with prediabetes, 4% with undiagnosed diabetes, 9% with diagnosed diabetes) with follow-up in 1990–2011 for hospitalizations. Participants were categorized by diabetes/HbA1c status: without diagnosed diabetes, HbA1c <5.7% (reference); prediabetes, 5.7 to <6.5%; undiagnosed diabetes, ≥6.5%; and diagnosed diabetes, <7.0 and ≥7.0%.RESULTSDemographic adjusted rates per 1,000 person-years of all-cause hospitalizations were higher with increasing diabetes/HbA1c category (Ptrend < 0.001). Persons with diagnosed diabetes and HbA1c ≥7.0% had the highest rates of hospitalization (3.1 times higher than those without a history of diagnosed diabetes, HbA1c <5.7%, and 1.5 times higher than those with diagnosed diabetes, HbA1c <7.0%, P < 0.001 for both comparisons). Persons with undiagnosed diabetes had 1.6 times higher rates of hospitalization and those with prediabetes had 1.3 times higher rates of hospitalization than those without diabetes and HbA1c <5.7% (P < 0.001 for both comparisons). Rates of hospitalization by diabetes/HbA1c category were different by race (Pinteraction = 0.011) and by sex (Pinteraction = 0.020). There were significantly excess rates of hospitalizations due to cardiovascular, endocrine, respiratory, gastrointestinal, iatrogenic/injury, neoplasm, genitourinary, neurologic, and infection causes among those with diagnosed diabetes compared with those without a history of diagnosed diabetes (all P < 0.05).CONCLUSIONSPersons with diagnosed diabetes, undiagnosed diabetes, and prediabetes are at a significantly elevated risk of hospitalization compared with those without diabetes. Substantial excess rates of hospitalizations in persons with diagnosed diabetes were for endocrine, infection, and iatrogenic/injury causes, which may be preventable with improved diabetes care.

Hospital admission in children and adolescents with or without type 1 diabetes from Germany: An analysis of statutory health insurance data on 12 million subjects

“…[7][8][9][10][11] Studies investigating the hospitalization risk in pediatric patients with T1D compared to that of the general population are scarce. [12][13][14][15] Overall, it is estimated that children with T1D are 3 to 5 times more likely to be hospitalized. [12][13][14] The last report from Germany dates back more than 15 years.…”

Emerging roles of RNA‐binding proteins in diabetes and their therapeutic potential in diabetic complications

“…Defects in insulin-mediated uptake of glucose into these target tissues cause chronic hyperglycemia in the bloodstream and trigger pathogenic signals including inflammation, hypertension, mitochondrial dysfunction, oxidative stress, endoplasmic reticulum (ER) stress, and dyslipidemia. Chronic hyperglycemia leads to systemic complications and increases the risk for cancer, infections, and Alzheimer's disease (Harcourt, Penfold, & Forbes, 2013;Schneider et al, 2016). Systemic complications of diabetes include: (a) vascular disease that can lead to heart attack and/or stroke (Dong et al, 2017;Shi & Vanhoutte, 2017); (b) neuropathy which causes pain and numbness (Chan & Tang, 2016;Conserva, Gesualdo, & Papale, 2016;Sheetz & King, 2002); (c) retinopathy that can progress into blindness (Aiello et al, 1998;Sheetz & King, 2002;Wilkinson-Berka & Miller, 2008);…”

Pathogenetic Mechanisms and Ways of Preventing Cardiovascular Complications of Diabetes Mellitus Type 2

“…Велике медико-соціальне значення проблеми ЦД 2 типу полягає в тому, що він призводить до ранньої інвалідізації та смертності, які обумовлені розвитком серцево-судинних ускладнень, таких як ІХС, інфаркт міокарда, інсульт, серцева недостатність, ретинопатія, нефропатія, ураження артерій нижніх кінцівок [32,65,81,85]. Проблема зниження смертності від серцево-судинних захворювань залишається предметом особливої уваги сучасної медицини, оскільки від ураження серцево-судинної системи вмирають 65-75 % хворих на ЦД 2 типу.…”

“…Загальновідомим фактом є те, що переважна більшість пацієнтів, які померли від серцевосудинних та церебральних захворювань, мали ЦД 2 типу як фонову коморбідну патологію. ЦД 2 типу є незалежним чинником ризику розвитку кардіоваскулярної патології, насамперед, ІХС, інфаркту міокарда, інсульту, патології периферійних артерій, а його значна розповсюдженість обумовлює зростання частоти серцево-судинних захворювань в популяції в цілому [27,51,85].…”