Comparison of incidence, rate and length of all-cause hospital admissions between adults with normoglycaemia, impaired fasting glucose and diabetes: a retrospective cohort study in Geelong, Australia

• Published in: BMJ open 2018-03, Vol.8 (3), p.e020346-e020346
• Main Authors: Sajjad, Muhammad Amber, Holloway, Kara L, de Abreu, Lelia L F, Mohebbi, Mohammadreza, Kotowicz, Mark A, Pedler, Daryl, Pasco, Julie A
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Alcohol; Australia; Blood Glucose - analysis; Cardiovascular disease; Cohort analysis; Comorbidity; Diabetes; Diabetes and Endocrinology; Diabetes Mellitus, Type 2 - epidemiology; Fasting; Female; Glucose; Health risk assessment; Hospitalization; Hospitalization - statistics & numerical data; Hospitals; Humans; Hypoglycemic Agents - therapeutic use; Incidence; Logistic Models; Male; Middle Aged; Patient admissions; Population; Prediabetic State - blood; Prediabetic State - drug therapy; Prediabetic State - epidemiology; Retrospective Studies; Risk Factors; Socioeconomic factors; Womens health; Young Adult
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2017-020346

ObjectiveTo determine whether adults with normoglycaemia, impaired fasting glucose (IFG) and diabetes differed according to the incidence, rate, length and primary reasons for hospital admission.DesignRetrospective cohort study.SettingBarwon Statistical Division, Geelong, Australia.ParticipantsCohort included 971 men and 924 women, aged 20+ years, participating in the Geelong Osteoporosis Study. Glycaemic status was assessed at cohort entry using fasting plasma glucose, use of antihyperglycaemic medication and/or self-report.Primary and secondary outcome measuresPrimary outcome measure was any admission to the major tertiary public hospital in the study region over the follow-up period. Secondary outcome measures were admission rate and length (days).ResultsOver a median follow-up of 7.4 years (IQR 5.3–9.6), participants with diabetes, compared with those with normoglycaemia, were two times as likely to be hospitalised (OR 2.07, 95% CI 1.42 to 3.02), had a higher admission rate (incidence rate ratio 1.61, 95% CI 1.17 to 2.23) and longer hospital stay (third quartile difference 7.7, 95% CI 1.3 to 14.1 and ninth decile difference 16.2, 95% CI 4.2 to 28.3). IFG group was similar to normoglycaemia for the incidence, rate and length of admission. Cardiovascular disease-related diagnoses were the most common primary reasons for hospitalisation across all glycaemic categories.ConclusionsOur results show increased incidence, rate and length of all-cause hospital admission in adults with diabetes as compared with normoglycaemia; however, we did not detect any associations for IFG. Interventions should focus on preventing IFG-to-diabetes progression and reducing cardiovascular risk in IFG and diabetes.