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Exp Clin Endocrinol Diabetes 2020; 128(09): 615-623
DOI: 10.1055/a-0972-1060
Article

Hospitalization in Pediatric Diabetes: A Nationwide Analysis of all Admission Causes for Germany in 2015

Marie Auzanneau‡
1   Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
2   German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
,
Joachim Rosenbauer‡
2   German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
3   Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
,
Andrea Icks
2   German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
4   Institute for Health Services Research and Health Economics, German Diabetes Center, Düsseldorf, Germany
5   Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Germany
,
Beate Karges
6   Division of Endocrinology and Diabetes, Medical Faculty, RWTH Aachen University, Aachen, Germany
,
Andreas Neu
7   University Children’s Hospital Tübingen, Tübingen, Germany
,
Ralph Ziegler
8   Diabetes Clinic for Children and Adolescents, Müenster, Germany
,
Wolfgang Marg
9   Center for Pediatrics and Adolescent Medicine, Bremen-Mitte Hospital, Bremen, Germany
,
Thomas Kapellen
10   Department of Women and Child Health, Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany
,
Paul-Martin Holterhus
11   Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, University Hospital of Schleswig-Holstein, Campus Kiel/Christian-Albrechts University of Kiel, Kiel, Germany
,
Reinhard W. Holl
1   Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
2   German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
› Author Affiliations Funding This work was supported by the German Center for Diabetes Research (DZD), by the German Diabetes Association (DDG), by the Association of Diabetic Children and Adolescents (BdKJ), and by the Robert Koch Institute (RKI). The ZIBMT, Institute of Epidemiology and Medical Biometry, University of Ulm, receives funding from the Innovative Medicines Initiative 2 Joint Undertaking INNODIA under grant agreement 115797, supported by the European Commission’s Horizon 2020 research and innovation program and European Federation of Pharmaceutical Industries and Associations, JDRF, and The Leona M. and Harry B. Helmsley Charitable Trust.
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Abstract

Introduction Regarding pediatric diabetes, hospital admission for acute complications of type 1 diabetes (T1D) has often been investigated, but little is known about other causes of hospitalization. This study aimed to explore the total burden of hospitalization in individuals with diabetes<20 years of age in Germany.

Methods Using the German Diagnosis-Related Groups data for 2015, we examined the frequencies of hospitalization with diabetes (20 251 inpatient cases), stratified by diabetes type [T1D, type 2 diabetes (T2D), other specified diabetes types (T3D), and unclear diabetes], and without diabetes (1 269 631 inpatient cases). Using estimates of the population at risk with T1D, T2D, and without diabetes, we evaluated hospitalization rates (per patient-year) by Poisson regression. For T1D, T2D, and T3D, we investigated the most frequent diagnoses and the median length of stay. Most analyses were stratified by sex, age-group and east/west residence.

Results Children and adolescents with diabetes had a 6 to 9 times higher hospitalization risk than peers without diabetes (hospitalization rate 0.09). The hospitalization rate was higher for T2D compared with T1D (0.84 vs. 0.53, P<0.001). In T2D, two-third of inpatient cases were not directly related to diabetes, and stay was shorter compared with T1D and T3D (3 vs. 4 and 5 days, respectively). In T1D, hospitalization was more frequent among girls than boys (0.58 vs. 0.49, P<0.001), and mostly due to “diabetes without complications” (65.7%). Hospitalization tended to be more frequent and longer in the youngest patients, and in those with east residence.

Conclusion Hospitalization rate in pediatric diabetes in Germany remained high, especially for T2D patients, girls with T1D, and young children.

Key words

Type 1 diabetes - type 2 diabetes - pancreatic diabetes - comorbidities - secondary data analysis - German DRG.

Supplementary Material



Publication History

Received: 14 May 2019
Received: 02 July 2019

Accepted: 09 July 2019

Article published online:
19 August 2019

© Georg Thieme Verlag KG
Stuttgart · New York

 

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