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Scot E. Moss, MA; Ronald Klein, MD, MPH; Barbara E. K. Klein, MD, MPH

Arch Intern Med. 1999;159:2053-2057.

Objective  To determine factors predicting hospitalization in people with diabetes.

Methods  Two population-based groups with diabetes were examined at baseline (1980-1982), 4 years (1984-1986), and 10 years (1990-1992). The younger-onset group (n=777) consisted of all persons diagnosed as having diabetes before age 30 years who were taking insulin, and the older-onset group (n=542) consisted of a sample of persons diagnosed after age 30 years. At the 10-year examination, participants were asked if they had been hospitalized in the previous year. Factors from the 4-year examination were examined for their ability to predict hospitalization at the 10-year examination.

Results  In the younger-onset group, 25.5% reported being hospitalized. In logistic models, glycosylated hemoglobin level (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.16-1.39 for a 1% increment) and hypertension (OR, 1.60; 95% CI, 1.08-2.38) predicted hospitalization. Factors that were not significant included age, sex, systolic and diastolic blood pressures, body mass, smoking status, and alcohol consumption. In the older-onset group, 30.8% reported being hospitalized. In logistic models, only glycosylated hemoglobin level (OR, 1.16; 95% CI, 1.06-1.29 for a 1% increment) predicted hospitalization.

Conclusions  Glycemic control is subject to intervention. Better control may decrease hospitalization among people with diabetes. Thus, there is considerable potential for reducing health care costs.

From the Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison.

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