Lesser Known Complications Hospitalizing More Patients With Type 2 Diabetes

Lesser known complications of type 2 diabetes mellitus (T2DM) are leading to more hospitalizations for conditions such as infections (i.e., pneumonia, sepsis), mental health disorders, and gastrointestinal conditions, according to a study presented at the September European Association for the Study of Diabetes Annual Meeting.

Among the comorbid complications for diabetes, only 4 traditional conditions—including cellulitis, heart failure, urinary tract infections, and skin abscesses—were leading causes of hospitalizations in men and women.

“Although traditional complications such as heart failure and cellulitis remain a substantial burden for people with T2DM, infections less commonly linked with diabetes and mental health disorders are emerging as leading causes of hospital admissions and have substantial burdens that sometimes exceed the top-ranked well-known complications,” said lead study author Dee Tomic, from the Baker Heart and Diabetes Institute, Melbourne, Australia, in a press release.

The research team examined hospital data from 456,265 patients with TD2M, 15 years of age and older, who were registered in the Australian Diabetes Registry between 2010 and 2017. They compared these data to data from 19 million Australians 15 years of age and older to estimate the relative risk of hospitalization among patients with T2DM compared to the general population.

The researchers divided diabetes complications into 3 categories:

Traditional complications—Vascular diseases, kidney failure, retinopathy and cataracts, neuropathy, obesity, infections linked to diabetes, and well-known diabetes complications (e.g., amputation).

Emerging complications—Liver disease, mental health disorders, various cancers (e.g., gastrointestinal), and uncommon infections associated with diabetes (including respiratory infections and sepsis).

Not commonly acknowledged complications—All other diagnoses.

Researchers found that individuals with T2DM had a greater risk of hospitalization from most medical conditions compared to the general population.Per 100,000 people, 364 men were annually hospitalized for cellulitis, followed by 241 with stress disorders and 228 patients with iron deficiency anemia.

Per 100,000 women with T2DM, 558 were hospitalized annually with iron deficiency anemia, followed by 332 individuals with complications of urinary tract infections, and 267 people with cellulitis. Lesser-known complications, such as depression, hospitalized 256 women, whereas 237 women with T2DM were hospitalized with gastrointestinal disorders.

“The much greater risk for most mental health diagnoses in the diabetes population reinforces the evidence for mental health disorders as an emerging complication of T2DM,” said senior author Dianna Magliano, head of Diabetes and Population Health at Monash University, Melbourne, Australia, in the press release.

Additionally, women with T2DM were twice as likely than the general population to be hospitalized with asthma.

The study had limitations in that it looked for observational associations and not cause and effect. Researchers also examined the population of a high-income country with white Caucasian individuals, which generalizes the findings.

“The unexpected finding of a large burden of anemia in both men and women with T2DM suggests the possibility of a biological link between diabetes and iron deficiency. To look at this and other novel findings in more detail, we must conduct further analyses as diabetes registries become more common to understand the effects of diabetes on all organs to guide prevention and management strategies,” Magliano said in the press release.

Reference

Diabetologia. Reasons for hospital admissions in people with type 2 diabetes are changing. EurekAlert! September 1, 2022. Accessed September 6, 2022. https://www.eurekalert.org/news-releases/963507