Diabetes hospitalizations rise dramatically for young women

Diabetes hospitalizations were up by 66 percent for all ages and sexes, but the number of diabetes hospitalizations among younger adults, ages 30-39, more than doubled from 1993 to 2006.

This pattern of hospitalizations echoes the dramatic increase in rates of obesity across the United States in the last 30 years, according to the study by the University of Michigan Health System.

Young women were 1.3 times more likely to be hospitalized than young men, and the authors believe this may be due to higher rates of obesity for women vs. men in this age group.

Another possibility, researchers say, is that women with diabetes may be sicker than their male counterparts, which could be related to the medical care they receive. For example, younger women with diabetes are less likely to receive preventive care for their diabetes.

"Our findings suggest that further attention must be paid to the young adult population," says study author Joyce Lee, M.D., a pediatric endocrinologist and researcher for the Child Health Evaluation and Research Unit at U-M C.S. Mott Children's Hospital.

"We need more diabetes prevention interventions targeting the young adult population, and women in particular, to prevent further increases in diabetes," she says. "In addition, we need more medical care interventions to improve the overall health of young adults with diabetes."

The findings by the team of diabetes, public health and women's health experts reveal a serious shift in the burden of diabetes and predict a heavy future financial toll.

Adjusting for inflation, hospital charges for diabetes in 2006 tallied $200.1 billion compared with $62.5 billion in 1993.

"As rates of diabetes continue to increase, particularly among young adults, the future economic burden on Medicare will only escalate as people age," says Lee.

Pregnancy is a well-known trigger for diabetes in women, but the new study shows it was not the biggest culprit.

Rather researchers believe the higher rates of hospitalizations among young women, ages 20-39, compared to men were potentially due to increases in diabetes prevalence related to the higher national rates of obesity for women vs. men in this age group.

Previous studies have shown that women with diabetes use less preventative care, are less likely to receive aggressive medical management and experience worse outcomes after hospitalization for cardiovascular problems. .

For the study, the team evaluated the Nationwide Inpatient Sample database, the largest database of hospital discharges. Other findings:

• Women vs. men. Starting in 1993, more women than men were hospitalized with diabetes even after exclusion of hospitalizations associated with pregnancy. Rates were higher among women in the younger age groups, but higher among men after age 50.
• Hospitalization trends. For all ages and sexes, diabetes hospitalizations increased, from 10.3 percent in 1993 to 17.6 percent 14 years later.

An estimated 24 million Americans have diabetes, a condition in which blood sugar levels are higher than normal. There is no cure, but those with diabetes can manage the disease with medications, a healthy diet and exercise. Diabetes is the sixth leading cause of death in the U.S.

Additional U-M authors: Matthew M. Davis, M.D., MAPP, associate professor of pediatrics and communicable diseases and internal medicine at the U-M Medical School and associate professor of public policy at U-M's Gerald R Ford School of Public Policy; Acham Gebremariam, M.S., CHEAR Unit; and Catherine Kim, M.D., M.P.H., assistant professor of internal medicine and obstetrics and gynecology.

Funding: National Institute of Diabetes and Digestive and Kidney Diseases and a Clinical Sciences Scholars Program at the University of Michigan.