title: Frequency and causes of hospitalization in older compared to younger adults with type 2 diabetes in the United States: a retrospective, claims-based analysis.
abstract: OBJECTIVE
  This study assessed the frequency and most common causes of hospitalization in older compared to younger adults with type 2 diabetes mellitus (T2DM) in the US.
  
  
  METHODS
  A retrospective study utilizing data from a nationally representative insurance claim database included patients who were diagnosed or treated for diabetes during or prior to the defined study period and who experienced hospitalization with or without re-hospitalization.
  
  
  RESULTS
  Among 887,182 patients with T2DM, 31% were ≥ 65 years old and nearly 1 in 4 (23.5%) were hospitalized during the observation period. Only 2.3% of first hospitalizations were determined to be diabetes-related, and these events were most commonly associated with a history of pre-study hospitalization and increasing age. Hypoglycemia was a common cause for T2DM-related hospitalizations (22.9%), and older patients demonstrated a higher proportion of hypoglycemia-related hospitalizations (age ≥ 65 years: 38.3% vs. age < 65 years: 11.4%). Survival analysis predicting readmission within 6 months after first hospitalization showed that primary factors associated with first readmissions were history of prior hospitalization, malignancy, insulin use, and presence of pre-existing liver or renal disease.
  
  
  CONCLUSIONS
  Hospitalization is common in patients with diagnosed diabetes, and nearly 1 in 4 diabetes-related hospital admissions were due to hypoglycemia. While the overall rate of hypoglycemia-associated admission was low, the age-specific rate was nearly 2.5-fold higher in older adults (≥ 65 years), affirming the need to carefully assess the potential benefit/risk of diabetes medications in those ≥ 65 years of age.
authors.affiliation: Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN.
authors.forename: Haoda
authors.initials: H
authors.lastname: Fu
authors.affiliation: Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN.
authors.forename: Bradley H
authors.initials: BH
authors.lastname: Curtis
authors.affiliation: Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN.
authors.forename: Wenting
authors.initials: W
authors.lastname: Xie
authors.affiliation: Eli Lilly and Company, Vienna, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Festa
authors.affiliation: Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN.
authors.forename: Dara P
authors.initials: DP
authors.lastname: Schuster
authors.affiliation: Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN. Electronic address: dkendall@lilly.com.
authors.forename: David M
authors.initials: DM
authors.lastname: Kendall
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015331:Cohort Studies; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000628:therapy; D005260:Female; D006264:Health Benefit Plans, Employee; D006760:Hospitalization; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced* / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D007328:Insulin / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D012189:Retrospective Studies; D016019:Survival Analysis; D014481:United States
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Hospital admission; Hypoglycemia; Older adults; Type 2 diabetes mellitus