Inpatient care of patients with type 1 diabetes mellitus by duration of diabetes and sex: A nationwide population-based longitudinal study.
OBJECTIVE
To describe hospitalizations of a cohort of patients with type 1 diabetes mellitus (T1DM) during 1973-1998 in the main complication groups by sex and T1DM lasting on average 9.5 or 16.5 years.


METHODS
The population (N = 5166) consisted of all Finnish patients with T1DM diagnosed before the age of 18 years between 1965-1979, derived from the Finnish population-based register of T1DM patients. Data on hospitalizations were obtained from the Finnish Hospital Discharge Register.


RESULTS
In the early stages of T1DM, the majority of the use of hospitalizations was due to the treatment of T1DM without complications. Enormous increases were found for complications when diabetes lasted longer (from 9.5 to 16.5 years). For women, the yearly number of bed-days for renal complications increased 4.8-fold, for peripheral vascular disease 4.3-fold, and for ophthalmic complications 2.5-fold. For men, the corresponding increases were as follows: 5-fold, 6.9-fold, and 2.5-fold. The yearly number of bed-days for nephropathy increased 7-fold. Bed-days for T1DM without complications dropped dramatically. The length of stay in hospitalizations decreased notably, but hospital visits increased when the duration of T1DM increased.


CONCLUSIONS
Hospitalizations due to complications substantially increase with aging of T1DM patients. Prevention of T1DM is strongly needed.
Welfare and Health Promotion Division, Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare (THL), Helsinki, Finland.
Markku J
MJ
Akkanen
Sirkka-Liisa
SL
Kivelä
Veli
V
Koistinen
Harri
H
Sintonen
Jaakko
J
Tuomilehto