title: The burden of hospitalization related to diabetes mellitus: a population-based study.
abstract: OBJECTIVE
  To estimate the impact of diabetes and its complications, overall and in different age classes, on the likelihood of hospital admission for specific causes.
  
  
  RESULTS
  We carried out a record-linkage analysis of administrative registers including data on 8,940,420 citizens in 21 Local Health Authorities in Italy. Individuals with pharmacologically treated diabetes (≥2 prescriptions of antidiabetic agents during the year 2008) were paired in a 1:1 proportion with those who did not receive such drugs (controls) based on propensity-score matching. Odds Ratios (ORs) of hospitalization for macro and microvascular conditions in individuals with diabetes as compared to controls were estimated. The system identified 498,825 individuals with diabetes pharmacologically treated (prevalence of 5.6%). Prevalence of diabetes in people aged <14 years, 14-39 years, 40-65 years, and ≥65 years was 0.1%, 0.6%, 6.4%, and 18.2%, respectively. Overall, 23.9% of subjects with diabetes and 11.5% of controls had had at least a hospital admission during 12 months for the causes considered. Diabetes increased the likelihood of hospitalization by two to six times for the different causes examined. In absolute terms, diabetes was responsible for an excess of over 12,000 hospital admissions per 100,000 individuals/year.
  
  
  CONCLUSIONS
  Despite the availability of effective treatments to prevent or delay major complications, diabetes still places an enormous burden on both patients and the health care system. Given the continuous rise in diabetes prevalence both in middle-aged and elderly individuals, we can expect an additional, hardly sustainable increase in the demand for health care in the near future.
authors.affiliation: Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Via Nazionale 8/a, S. Maria Imbaro, Italy.
authors.forename: G
authors.initials: G
authors.lastname: De Berardis
authors.forename: A
authors.initials: A
authors.lastname: D'Ettorre
authors.forename: G
authors.initials: G
authors.lastname: Graziano
authors.forename: G
authors.initials: G
authors.lastname: Lucisano
authors.forename: F
authors.initials: F
authors.lastname: Pellegrini
authors.forename: S
authors.initials: S
authors.lastname: Cammarota
authors.forename: A
authors.initials: A
authors.lastname: Citarella
authors.forename: C A
authors.initials: CA
authors.lastname: Germinario
authors.forename: V
authors.initials: V
authors.lastname: Lepore
authors.forename: E
authors.initials: E
authors.lastname: Menditto
authors.forename: A
authors.initials: A
authors.lastname: Nicolosi
authors.forename: F
authors.initials: F
authors.lastname: Vitullo
authors.forename: A
authors.initials: A
authors.lastname: Nicolucci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001549:Benzamides / Q000627:therapeutic use; D017281:Cost of Illness; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007558:Italy / Q000453:epidemiology; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D045162:Thiazolidinediones / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001549:Benzamides; D007004:Hypoglycemic Agents; D007328:Insulin; D045162:Thiazolidinediones; C030516:meglitinide; D008687:Metformin