Diabetes and prediabetes and risk of hospitalization: The atherosclerosis risk in communities (ARIC) study

Andrea L.C. Schneider, Rita R. Kalyani, Sherita Golden, Sally C. Stearns, Lisa Wruck, Hsin Chieh Yeh, Josef Coresh, Elizabeth Selvin

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE: To examine the magnitude and types of hospitalizations among persons with prediabetes, undiagnosed diabetes, and diagnosed diabetes. RESEARCH DESIGN AND METHODS: This study included 13,522 participants in the Atherosclerosis Risk in Communities (ARIC) study (mean age 57 years, 56% female, 24% black, 18% with prediabetes, 4% with undiagnosed diabetes, 9% with diagnosed diabetes) with follow-up in 1990-2011 for hospitalizations. Participants were categorized by diabetes/HbA1c status: without diagnosed diabetes, HbA1c <5.7% (reference); prediabetes, 5.7 to <6.5%; undiagnosed diabetes, ≥6.5%; and diagnosed diabetes, <7.0 and ≥7.0%. RESULTS: Demographic adjusted rates per 1,000 person-years of all-cause hospitalizations were higher with increasing diabetes/HbA1c category (Ptrend < 0.001). Persons with diagnosed diabetes and HbA1c ≥7.0% had the highest rates of hospitalization (3.1 times higher than those without a history of diagnosed diabetes, HbA1c <5.7%, and 1.5 times higher than those with diagnosed diabetes, HbA1c <7.0%, P <0.001 for both comparisons). Persons with undiagnoseddiabetes had1.6 times higher rates of hospitalization and those with prediabetes had 1.3 times higher rates of hospitalization than those without diabetes and HbA1c <5.7% (P < 0.001 for both comparisons). Rates of hospitalization by diabetes/HbA1c category were different by race (Pinteraction = 0.011) and by sex (Pinteraction = 0.020). There were significantly excess rates of hospitalizations due to cardiovascular, endocrine, respiratory, gastrointestinal, iatrogenic/injury, neoplasm, genitourinary, neurologic, and infection causes among those with diagnosed diabetes compared with those without a history of diagnosed diabetes (all P < 0.05). CONCLUSIONS: Persons with diagnosed diabetes, undiagnosed diabetes, and prediabetes are at a significantly elevated risk of hospitalization compared with those without diabetes. Substantial excess rates of hospitalizations in persons with diagnosed diabetes were for endocrine, infection, and iatrogenic/injury causes, which may be preventable with improved diabetes care.

LanguageEnglish (US)
Pages772-779
Number of pages8
JournalDiabetes care
Volume39
Issue number5
DOIs
StatePublished - May 1 2016

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Prediabetic State
Atherosclerosis
Hospitalization
Urogenital Neoplasms
Wounds and Injuries
Infection
Nervous System
Research Design
Demography

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Schneider, A. L. C., Kalyani, R. R., Golden, S., Stearns, S. C., Wruck, L., Yeh, H. C., ... Selvin, E. (2016). Diabetes and prediabetes and risk of hospitalization: The atherosclerosis risk in communities (ARIC) study. Diabetes care, 39(5), 772-779. DOI: 10.2337/dc15-1335

Diabetes and prediabetes and risk of hospitalization : The atherosclerosis risk in communities (ARIC) study. / Schneider, Andrea L.C.; Kalyani, Rita R.; Golden, Sherita; Stearns, Sally C.; Wruck, Lisa; Yeh, Hsin Chieh; Coresh, Josef; Selvin, Elizabeth.

In: Diabetes care, Vol. 39, No. 5, 01.05.2016, p. 772-779.

Research output: Contribution to journalArticle

Schneider, ALC, Kalyani, RR, Golden, S, Stearns, SC, Wruck, L, Yeh, HC, Coresh, J & Selvin, E 2016, 'Diabetes and prediabetes and risk of hospitalization: The atherosclerosis risk in communities (ARIC) study' Diabetes care, vol. 39, no. 5, pp. 772-779. DOI: 10.2337/dc15-1335
Schneider ALC, Kalyani RR, Golden S, Stearns SC, Wruck L, Yeh HC et al. Diabetes and prediabetes and risk of hospitalization: The atherosclerosis risk in communities (ARIC) study. Diabetes care. 2016 May 1;39(5):772-779. Available from, DOI: 10.2337/dc15-1335
Schneider, Andrea L.C. ; Kalyani, Rita R. ; Golden, Sherita ; Stearns, Sally C. ; Wruck, Lisa ; Yeh, Hsin Chieh ; Coresh, Josef ; Selvin, Elizabeth. / Diabetes and prediabetes and risk of hospitalization : The atherosclerosis risk in communities (ARIC) study. In: Diabetes care. 2016 ; Vol. 39, No. 5. pp. 772-779
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