09:38pm Saturday 21 October 2017

Kids with type 1 diabetes almost five times as likely to be hospitalised

Pre-schoolers and those from disadvantaged backgrounds are most at risk, the findings from the universities of Bristol, Cardiff and Swansea indicate.

The number of new cases of childhood type 1 diabetes has been rising steadily by around three to four per cent a year, the evidence shows, and the risk of death among those with the condition under the age of 30 is nine times that of the general public.

The researchers analysed the causes of hospital admission after being diagnosed with type 1 diabetes among 1,577 Welsh children up to the age of 15.

All these children had been diagnosed with type 1 diabetes between 1999 and 2009, and their details entered into the Brecon Group Register—a network of healthcare professionals caring for children and young people with diabetes normally resident in Wales.

Around one in five children had been diagnosed with type 1 diabetes before the age of five; two in five had been diagnosed after the age of ten.

Their hospital records were compared with those for 7,800 children admitted to hospital up to May 2012, who had been randomly selected from the Patient Episode Database for Wales (PEDW), and matched for birthday, sex, and residential area.

The results showed that children with type 1 diabetes were almost five times as likely to be admitted to hospital for any cause as their peers.

Pre-schoolers were at highest risk of admission. After the age of five the risk fell by more than 15 per cent for every five year rise in age at diagnosis.

Although there was no gender difference in risk, coming from a disadvantaged background was associated with an increased risk of hospital admission.

And those whose outpatient care was delivered at large centres were 16 per cent less likely to be admitted to hospital as those treated in small centres. Most (78 per cent) of those treated at large centres lived in urban areas.

Research leads Adrian Sayers from the University of Bristol and Professor John Gregory from Cardiff University, said: “It is unsurprising that complications of suboptimal management, such as hypoglycaemia [low blood sugar] and ketoacidosis [excess sugar and acid in the blood] will lead to hospitalisation in children with type I diabetes.

“However, the excess in admissions in children from more deprived areas, and of younger age will create personal costs to the individual and their families, and will have a financial toll on the NHS.

“This is an area of great clinical importance as patients admitted to hospital with diabetes aged under 30 years have a death rate nine times that of the general population.”

Paper

Evidence for a persistent, major excess in all cause admissions to hospital in children with type 1 diabetes: results from a large Welsh national matched community cohort study’ by Adrian Sayers et al in BMJ Open

University of Bristol


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