A Welsh analysis finds that children with type 1 diabetes have a fivefold increased risk of being admitted to hospital compared to children without the condition.
The analysis, conducted by researchers at the University of Cardiff and the University of Bristol, examined 1577 Welsh children aged 0-15 between 1999 and 2009. 7,800 controls were also assessed that matched on age, sex and socioeconomic status.
The children with type 1 diabetes were compared to the control participants as to how many times they were admitted to hospital, not including within the first 30 days of their diabetes diagnosis.
The type 1 children had a 4.9 incidence rate ratio (IRR) of being admitted to hospital, with study author Dr. John Gregory, MD, Cardiff University, saying these findings indicated “a much higher admission rate with type 1 diabetes.”
Younger children with type 1 diabetes under the age of five had the highest increased risk of hospital admissio, while those with type 1 in lower socioeconomic status groups also had a higher risk of hospitalisation.
Additionally, patients receiving outpatient care at large centres had a reduction in hospital admissions compared to those treated at small centres.
There was no evidence of a differential admission rate between boys and girls, and because Wales has a predominantly white population, it was not possible for the analysis to examine outcomes by racial group.
Gregory, discussing these findings at the Diabetes Professional Care meeting in London, said: “There is no sign that this is improving; we need to think about the potential for interventions to reduce this difference [between those with and without type 1 diabetes].”
Gregory added type 1 diabetes management in children is “demanding due to a complex treatment regimen,” and it is “unsurprising that complications of suboptimal management, such as hypoglycemia and ketoacidosis, occur, leading to hospitalisation.”
The research team hope these findings lead to increased out-of-hours care for patients to reduce hospital admission rates, and for prevention programs to be developed to help those most vulnerable to diabetic ketoacidosis (DKA).
DKA is a dangerous short-term complication that occurs when blood sugars are too high. It can be life-threatening if not treated urgently. Roughly one in four people with type 1 diabetes are suffering with DKA at the time of their diagnosis.
The findings were published in BMJ Open.

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