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Hospitalizations Way Up for Young Adults With Diabetes
Date:10/17/2010

By Kathleen Doheny
HealthDay Reporter

FRIDAY, Oct. 15 (HealthDay News) -- Hospitalizations for diabetes in the United States rose 65 percent over a recent 14-year span, with young adults -- and young women in particular -- accounting for much of that surge, a new study shows.

The number of 30- to 39-year-olds hospitalized for diabetes more than doubled between 1993 and 2006, the researchers found. Young women in that age bracket and also those aged 20 to 29 were 1.3 times more likely than men to need hospital care for diabetes, they said.

"What we saw were dramatic increases in diabetes-related hospitalizations for 30- to 39-year olds and particularly for women in that age group compared to men," said study leader Dr. Joyce M. Lee, an assistant professor of pediatrics at the University of Michigan.

The numbers came as no surprise to Dr. Fouad Kandeel, chair of the department of diabetes, endocrinology and metabolism at City of Hope Comprehensive Cancer Center in Duarte, Calif.

"Diabetes is on the rise worldwide," he said. "We are living in a pandemic of diabetes. We don't have the resources to combat it. Diabetes is happening earlier and earlier."

The research was published online Oct. 12 in the Journal of Women's Health.

Using the Nationwide Inpatient Sample, Lee looked at hospitalization data that included diabetes as a primary or secondary diagnosis during that time period. The hospitalizations were assumed to be diabetes-related, Lee said. For instance, diabetics are more likely to get infections, so they might be hospitalized for pneumonia.

Pregnancy often triggers diabetes in women, but their higher hospitalization rate continued even after excluding pregnancy-related hospitalizations. But after 50, men were more likely to be hospitalized.

Lee conducted the research because of general concern about rising rates of diabetes, particularly in a younger population, and obesity. Maintaining a healthy weight reduces the risk of developing the condition.

"We in particular were interested in younger adults because my suspicion is, that is going to be the new wave," she said.

In the United States, about 18 million people have diagnosed diabetes, according to the American Diabetes Association, but millions more are thought to have it without knowing it. The overwhelming majority have type 2 diabetes, in which the body does not make enough insulin or use the hormone properly. Insulin enables the body to utilize glucose, or sugar, as fuel.

Kandeel, like other experts, blames obesity as a major trigger for soaring rates of both diabetes and associated hospitalizations. "Behavior modification is a must if we are to make any impact on this very high rate of diabetes that is threatening the future generation," he said. Much research, he said, has proven that a healthy diet and regular exercise help greatly to delay or prevent type 2 diabetes.

The gender gap in diabetic hospitalizations surprised Lee, and she can only speculate on its cause.

Women with diabetes may be sicker than their male counterparts, because they don't get optimal care, she said.

Also, women have higher rates of obesity than men, the researchers noted. And women with diabetes often have depression, and that may affect the course of the disease, Lee said.

The new research, Lee said, "calls attention to the issue of young adults [and diabetes]. We need to focus on the prevention of diabetes in the young adult population."

It's possible that their study overstates the problem, the authors said, noting increased awareness of diabetes or multiple per-patient hospitalizations may have affected the findings. Further studies are needed to confirm the results and guide efforts to care and pay for this growing patient group, they concluded.

Hospital fees for diabetes in 2006 totaled $200.1 billion compared with $62.5 billion in 1993, after adjusting for inflation, the study found. That economic burden will continue rising as the population ages, the authors said.

For now, those already diagnosed with diabetes can improve the outlook by seeing their doctor on a regular basis, Lee noted.

More information

To learn more about preventing or delaying diabetes, visit the American Diabetes Association.

SOURCES: Joyce M. Lee, M.D., M.P.H., assistant professor, pediatrics, University of Michigan, Ann Arbor; Fouad Kandeel, M.D., Ph.D., chair, department of diabetes, endocrinology and metabolism, City of Hope Comprehensive Cancer Center, Duarte, Calif.; Oct. 12, 2010, Journal of Women's Health, online


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