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Trends in Hospitalizations for Diabetes Among Children and Young Adults

United States, 1993–2004

¹ Pediatric Endocrinology Unit, University of Michigan, Ann Arbor, Michigan
² Child Health Evaluation and Research (CHEAR) Unit, University of Michigan, Ann Arbor, Michigan
³ Division of General Pediatrics, University of California, San Francisco, San Francisco, California
⁴ Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
⁵ Gerald Ford School of Public Policy, University of Michigan, Ann Arbor, Michigan

Address correspondence and reprint requests to Joyce Lee, MD, MPH, 300 NIB, Room 6E05, Ann Arbor, MI 48109-5456. E-mail: joyclee{at}umich.edu

OBJECTIVE—The purpose of this study was to examine national trends in hospitalizations associated with diabetes for U.S. children and young adults.

RESEARCH DESIGN AND METHODS—The study included hospital discharges for individuals aged 0–29 years with a diagnosis of diabetes (250.xx) in the Nationwide Inpatient Sample (1993–2004). Outcomes were weighted, nationally representative estimates of the frequency of population-adjusted hospital discharges and hospital charges (2004 $U.S.).

RESULTS—Among individuals aged 0–29 years, population-adjusted rates of hospitalizations associated with diabetes over the 12-year period increased by 38% (99.1 of 100,000 in 1993 and 136.4 of 100,000 in 2004; P < 0.001 for curvilinear trend). Age-specific increases in annual hospitalizations for diabetes occurred primarily among individuals aged 20–24 years (152.6 of 100,000 in 1993 and 222.2 of 100,000 in 2004) and 25–29 years (224.9 of 100,000 in 1993 and 331.2 of 100,000 in 2004). Trends in hospitalizations among younger individuals showed no significant patterns. Hospitalization rates were consistently higher for females than for males, with a greater rate of increase for females (42%) than for males (29%) (P < 0.001). Inflation-adjusted total charges for diabetes hospitalizations increased 130%, from $1.05 billion in 1993 to $2.42 billion in 2004.

CONCLUSIONS—The number of young adults hospitalized with diabetes in the U.S. has increased significantly over the last decade. Sex-specific differences in hospitalization rates and trends in obesity among U.S. children may amplify future trends in diabetes hospitalizations and corresponding rapid growth in associated health care expenditures.

Abbreviations: CPI, Consumer Price Index • NIS, Nationwide Inpatient Sample • PPV, positive predictive value

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