Risk factors for hospitalization due to diabetes complications.
OBJECTIVE
To determine risk factors monitored in primary care that were significantly associated with diabetes complications requiring hospitalization.


METHODS
We examined clinical and demographic data for 1080 Type 1 and 11,283 Type 2 New Zealand diabetes patients attending a free primary care diabetes examination between 2000 and 2002. Hospital admissions data for the 2 years following the index examination were linked for each patient using a unique National Health Index code. Logistic regression was used to determine odds ratios for the likelihood of developing diabetic complications adjusted for each variable.


RESULTS
In the Type 1 cohort, 222 patients (20.6%) were hospitalized for diabetes complications and 1948 patients (17.3%) in the Type 2 cohort. In both cohorts, patients admitted with diabetes complications had significantly higher mean glycosylated haemoglobin (HbA1c) (p<0.001) and triglyceride levels (p<0.001), urine albumin:creatinine ratios (p<0.001) and duration of diabetes (p<0.01 Type 1: p<0.001 Type 2) than patients not admitted. In Type 2 patients, age, obesity, HbA1c, urine albumin:creatinine ratios, HDL levels and treatment with insulin or oral medication were all associated with increased odds of admission.


CONCLUSIONS
Although it is well known that HbA1c is a significant predictor of diabetes complications, this study shows that urine albumin:creatinine ratio, body mass index, triglycerides and high density lipoproteins are also independent predictors of hospitalization for diabetes complications. Attention to all these factors in the primary care setting is indicated if the burden of diabetes complications to hospital services is to be minimized.
Tomlin
Andrew M
AM
Royal New Zealand College of General Practitioners' Research Unit, Department of General Practice, Dunedin School of Medicine, University of Otago, P.O. Box 913, Dunedin, New Zealand.
Dovey
Susan M
SM
Tilyard
Murray W
MW
D000328:Adult; D017668:Age of Onset; D000368:Aged; D002318:Cardiovascular Diseases / Q000145:classification / Q000628:therapy; D002986:Clinical Trials as Topic; D015331:Cohort Studies; D048909:Diabetes Complications / Q000191:economics / Q000628:therapy*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000191:economics; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000191:economics; D003925:Diabetic Angiopathies / Q000628:therapy; D003929:Diabetic Neuropathies / Q000628:therapy; D003930:Diabetic Retinopathy / Q000628:therapy; D004469:Economics, Hospital; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D012307:Risk Factors