Background:
The rise in prevalence of type 2 diabetes mellitus (T2DM) in children is well recognized; however, its effect on diabetes‐related hospitalization rates is not well characterized. The objective of this study was to examine the trends in the hospitalization and characteristics of children admitted with a diagnosis of T2DM.
Methods:
Hospital discharge rates of children with type 1 diabetes mellitus (T1DM) and T2DM were compared in the 1997, 2000, and 2003 Kids Inpatient Databases (KID). Admissions for primary diagnoses of diabetes were identified by ICD9 codes. Data from the 2003 KID were further analyzed for associations between T2DM discharges and child and hospital characteristics. Discharges for T1 DM and T2DM in the 2003 KID were compared in length of stay, number of additional diagnoses, and hospital charges. Categorical data were analyzed using chi‐square and logistic regression analyses. Differences between means were analyzed using the Student t test. All statistical procedures were performed using SUDAAN software.
Results:
The prevalence of T2DM discharges (per 10,000 children) increased 176%: from 5.1 in 1997 to 11.7 in 2000 to 14.1 in 2003 (P < .0001), whereas discharges for T1DM increased by only 15%. In 2003 black, Native American, and Hispanic children were 1.3, 2.7, and 3.2 times more likely, respectively, than white children to have a discharge diagnosis of T2DM (P < .0001). T2DM discharge was more likely for male patients than female patients (OR = 1.3, P < .0001). T2DM discharge rates varied significantly with age: 5‐8 years = 7.3, 9‐12 years = 26.8, 13‐17 years = 21.9, and 18‐20 years = 14.6 (P < .0001). There were no significant variations in T2DM hospital discharges by season. In logistic regression, ethnicity, sex, and age remained significant. Compared to T1DM, admissions for T2DM had a longer length of stay (LOS), 2.9 versus 2.6 days (P < .0001), and more diagnoses on record, 3.3 versus 2.9 (P < .0001). Total hospital charges were similar ($9144 vs. $8818; P = .28).
Conclusions:
Mirroring the recent increase in T2DM prevalence, T2DM admissions of children are increasing dramatically. Black, Hispanic, and Native American children are disproportionately affected, and the rate of T2DM hospitalization among 9‐ to 12‐year‐olds is surprisingly high. Despite costs similar to T1DM hospitalization, longer LOS and more concurrent diagnoses could suggest greater morbidity among children hospitalized with T2DM.
Author Disclosure:
R. Graves, None; D. Rauch, None; J. Brodsky, None; A. Fierman, None; G. Fryer, None; T. Miyoshi, None; M. Weitzman, None.