Age and sex differences in hospitalizations associated with diabetes

Aim: To evaluate national trends in hospitalizations and hospital charges associated with diabetes over a recent 14-year period. Methods: We evaluated hospital discharges with a primary or secondary diagnosis of diabetes (250.xx)in the Nationwide Inpatient Sample (1993-2006). Outcomes included population-adjusted estimates of hospital discharges and hospital charges (2006 $U.S.). Results: Overall, discharges associated with diabetes increased 65.3% (1,384/100,000 in 1993, 2,288/100,000 in 2006) over the 14-year period (p<0.001 test for trend). The largest increase in hospitalizations occurred among adults 30-39 years of age, representing a 102% increase. Among young adults, increases among women were ∼1.3 times greater compared with men, for the 20-29 year (63% vs. 46%) and 30-39 year (118% vs. 85%) age groups, even after excluding pregnancy-related hospitalizations. Overall, women had higher rates of hospitalizations associated with diabetes compared with men, but there was evidence of an age by sex interaction, with higher rates of hospitalizations among women in the younger age groups and among men in the older age groups. Annual inflation-adjusted total charges for hospitalizations with diabetes increased 220% over the period. Conclusions: Large increases in diabetes hospitalizations occurring among adults aged 30-39 years and young women signal a shift in the hospital burden of diabetes.