Baker Heart and Diabetes Institute, Melbourne, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Diabet Med. 2024 Jan;41(1):e15218. doi: 10.1111/dme.15218. Epub 2023 Sep 11.
To determine the incidence of hospitalisation for all diagnoses among Australian youth with type 1 diabetes.
We linked Australians aged under 20 years with type 1 diabetes on the National Diabetes Services Scheme (n = 45,685) to hospital admission data from 2010 to 2019. We determined relative risks (RR) of hospitalisation among those with type 1 diabetes in the states of Victoria and Queensland (n = 21,898) compared to the general population for 2010-2017 using Poisson regression.
Australian youth with type 1 diabetes had increased risk for almost all reasons for hospitalisation compared to the general population, especially infections such as anogenital herpesviral infections (RR 54.83, 95% CI 33.21-90.53), and mental health disorders including personality disorders (RR 9.70, 95% CI 8.02-11.72). Among those with type 1 diabetes, over 60% of hospitalisations were directly related to diabetes, almost half of which were for ketoacidosis. Approximately 15% of ketoacidosis admissions occurred within 3 months of diabetes diagnosis. One quarter of those with admissions for ketoacidosis were readmitted for ketoacidosis within 12 months. Residence in areas of high socio-economic disadvantage was an independent risk factor for admission and readmission for ketoacidosis.
Youth with type 1 diabetes are susceptible to a wide range of complications. Clinicians should consider screening and prevention for conditions such as infections and mental health disorders. Targeted support and education around glycaemic management should be considered in those at high risk for ketoacidosis admission including those living in areas of high socio-economic disadvantage.
确定澳大利亚青少年 1 型糖尿病患者的所有诊断住院率。
我们将参加国家糖尿病服务计划（National Diabetes Services Scheme，NDS）的年龄在 20 岁以下的澳大利亚 1 型糖尿病患者（n=45685）与 2010 年至 2019 年的住院数据进行链接。我们使用泊松回归，比较维多利亚州和昆士兰州（n=21898）的 1 型糖尿病患者与普通人群 2010-2017 年的住院率相对风险（RR）。
与普通人群相比，澳大利亚青少年 1 型糖尿病患者因几乎所有原因住院的风险均增加，尤其是生殖器疱疹病毒感染等感染（RR 54.83，95%CI 33.21-90.53）和包括人格障碍在内的心理健康障碍（RR 9.70，95%CI 8.02-11.72）。在 1 型糖尿病患者中，超过 60%的住院与糖尿病直接相关，其中近一半是由于酮症酸中毒。大约 15%的酮症酸中毒入院发生在糖尿病诊断后的 3 个月内。四分之一的酮症酸中毒入院患者在 12 个月内因酮症酸中毒再次入院。居住在社会经济劣势高的地区是入院和酮症酸中毒再入院的独立危险因素。
青少年 1 型糖尿病患者易患多种并发症。临床医生应考虑对感染和心理健康障碍等疾病进行筛查和预防。对于那些有酮症酸中毒入院风险的患者，包括居住在社会经济劣势高地区的患者，应考虑在血糖管理方面提供有针对性的支持和教育。
