Hospitalization among diabetic children and adolescents and non-diabetic control subjects: a prospective population-based study

Aim/hypothesis. Data comparing the hospitalization of diabetic paediatric p atients with the non-diabetic population is scarce. We undertook a populati on-based incidence study to compare hospitalization in a cohort of Type I d iabetic children and adolescents, in Germany, in the first course of treatm ent after diabetes onset, with hospitalization in non-diabetic control subj ects matched for age, sex, and region. Methods. A total of 373 subjects with newly diagnosed diabetes (onset betwe en 1 and under 15 (< 15) years of age in 1996 and 1997, 54% male, mean age at diagnosis 7.6 +/- 3.8 years) and 783 non-diabetic control subjects match ed for age, sex, and region were followed for 1 year on average. Hospital a dmissions and the length of stay (days) were assessed by written questionna ires. Incidence rates of hospitalization and the expected number of hospita l days per person-year were estimated for both cohorts. Using Poisson regre ssion, we estimated ratios of hospitalization incidence rates (IRRs) and of expected numbers of hospital days (DRRs) in the diabetic cohort compared t o the non-diabetic cohort, adjusting for age, sex and social status. Results. Hospitalization incidence rates and hospital days, expressed per p erson-year (95%-CI), were 0.34 (0.29-0.39) and 2.36 (2.22-2.50) in the diab etic cohort and 0.07 (0.05-0.09) and 0.29 (0.26-0.33) in the non-diabetic c ohort, respectively. Among diabetic subjects, both parameters were associat ed with higher age and female sex. IRR and DRR (95%-CI) were 4.7 (3.5-6.5) and 7.7 (6.7-8.9). Conclusion/interpretation. In the first year after onset, children and adol escents with diabetes had a 4.7 times higher hospitalization risk and spent 7.7 times more days in hospital than non-diabetic subjects. The ratios wer e smaller than those in Finland and Denmark in the 1980s, most likely due t o differences between health care systems and time trends.