Study identifies different reasons for hospital admissions in people with type 2 diabetes

Common reasons for hospital admissions among people with type 2 diabetes are altering, new evidence reveals.

A team of researchers have found that non-traditional diabetes complications – such as mental health disorders – are leading to hospitalisations, the study has reported.

Infections and gastrointestinal conditions have also been found to increase hospital admissions in people with type 2 diabetes.

According to the study, the most common diabetes-related problems that cause hospitalisations are skin abscesses, cellulitis, heart failure and urinary tract infections.

Chief author Dr Dee Tomic said: “Although traditional complications such as heart failure and cellulitis remain a substantial burden for people with type 2 diabetes, infections less commonly linked with diabetes and mental health disorders are emerging as leading causes of hospital admissions and have substantial burdens that sometimes exceed the top-ranked well-known complication.

“The emergence of non-traditional diabetes complications reflects improvements in diabetes management and people with diabetes living longer, making them susceptible to a broader range of complications.”

She evaluated: “Increasing hospitalisations for mental health disorders as well as infections like sepsis and pneumonia will place extra burden on healthcare systems and may need to be reflected in changes to diabetes management to better prevent and treat these conditions.”

Better preventive care and management has reduced the number of type 2 diabetes hospital admissions over the past two decades, research shows.

During the study, a team of academics examined the health of half of people living in Australia wit type 2 diabetes.

Modelling was used to identify the leading individual diagnosis-level causes of hospitalisation among people with type 2 diabetes and to estimate the relative risk of hospitalisation compared to the general population, after adjusting for age and calendar-year effects.

Overall, the analyses found that people with type 2 diabetes are at greater risk of being hospitalised with most medical conditions compared to the general population.

The leading cause of excess hospitalisations in men with type 2 diabetes was cellulitis, responsible for 364 excess annual hospitalisations per 100,000 men with type 2 diabetes, followed by the lesser-recognised complications of stress disorders (241 per 100,000) and iron deficiency anaemia (228 per 100,000) — with diabetes doubling the risk of admission for these conditions compared to the general population.

In women with type 2 diabetes, iron deficiency anaemia was the leading cause of excess annual admissions (558 per 100,000), followed by the traditional complications of urinary tract infections (332 per 100,000) and cellulitis (267 per 100,000).

High rates of excess hospitalisation were also noted for lesser-known complications including depression (256 per 100,000), gastrointestinal disorders (237 per 100,000) and asthma (192 per 100,000) — with hospitalisations for asthma more than twice as likely amongst women with type 2 diabetes compared to the general population.

Joint researcher Professor Dianna Magliano said: “The much greater risk for most mental health diagnoses in the diabetes population reinforces the evidence for mental health disorders as an emerging complication of type 2 diabetes.

“The unexpected finding of a large burden of anaemia in both men and women with type 2 diabetes suggests the possibility of a biological link between diabetes and iron deficiency.”

She added: “To look at this and other novel findings in more detail, we must conduct further analyses as diabetes registries become more common to understand the effects of diabetes on all organs to guide prevention and management strategies.”

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