Kids With Type 1 Diabetes Face Much Higher Hospitalization Rates

British study finds fivefold jump in admissions, especially for the youngest, poorest patients

MONDAY, April 13, 2015 (HealthDay News) -- Children with type 1 diabetes are nearly five times more likely to be hospitalized than those without the disease, a new British study finds.

The risk is highest among preschoolers and children in poor families.

"Children with diabetes are at an unacceptably increased risk of being admitted to hospital," John Gregory, a professor and specialist in pediatric endocrinology at Cardiff University School of Medicine, said in a university news release.

The situation may not be much different for American children, one expert said.

"These findings are likely to be similar in the United States," said Dr. Sofia Shapiro, a pediatric endocrinologist at Northern Westchester Hospital in Mount Kisco, N.Y. "Younger children with type 1 diabetes have more emergency room visits and hospitalizations, compared to older children and adolescents."

Type 1 diabetes is an autoimmune disease that destroys insulin-producing cells in the pancreas. About 5 percent of all cases of diabetes are type 1 diabetes.

In its study, Gregory's team tracked data from almost 1,600 Welsh infants and children up to age 15, all of who had type 1 diabetes. The researchers found that these children were almost five times more likely to be hospitalized than children without the disease.

The risk of hospitalization among children with type 1 diabetes was highest for children aged 5 and under, the research team found. After that, the risk for hospitalization fell by 15 percent for every five-year increase in a child's age at the time of diagnosis.

Children with type 1 diabetes who came from poorer families were at especially high risk for hospitalization, according to the study published April 13 in the journal BMJ Open.

"Based on this evidence, clinical services need to look at ways of supporting the care of those most at risk: the very young and those from poorer backgrounds," Gregory said.

Shapiro said that age is an important factor in shaping the odds that a child with type 1 diabetes will need hospital care.

Younger children "likely have less reserve and may not be as attuned to sensing low blood sugars," she explained. They may also be less able to communicate to parents and others the symptoms of a common and life-threatening complication of type 1 diabetes called diabetic ketoacidosis, Shapiro said. Those symptoms include abdominal pain or nausea, she said.

Dr. Patricia Vuguin is a pediatric endocrinologist at Cohen Children's Medical Center in New Hyde Park, N.Y. She noted that "the incidence of type 1 diabetes in childhood is increasing by three to four percent per year, mainly in preschool-aged children, leading to increasing demands on services and more health care expenditures."

According to Vuguin, the illness is linked to a number of other ailments, such as "diabetes ketoacidosis, heart disease, kidney disease, eye problems and chronic foot problems."

She added that in the United States, there's been increasing efforts to deliver care to children with type 1 diabetes on an outpatient basis. However, "no change in the hospital admission rates has been seen over time, despite new treatments and more stringent recommendations regarding management" of the illness, Vuguin said.

More information

The U.S. National Library of Medicine has more about type 1 diabetes.

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