ArticleBMJ open2015
Evidence for a persistent, major excess in all cause admissions to hospital in children with type-1 diabetes: results from a large Welsh national matched community cohort study.
Article in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 27 citations in OpenAlex.
- Correlation Among Hypoglycemia, Glycemic Variability, and C-Peptide Preservation After Alefacept Therapy in Patients with Type 1 Diabetes Mellitus: Analysis of Data from the Immune Tolerance Network T1DAL Trial.Clinical therapeutics · 2016Trial
- Social Determinant of Health Impact on Diabetes Device Use and Clinical Outcomes in Youth with Type 1 Diabetes.Pediatric diabetes · 2023Article
- Article
- Risk factors for having diabetic retinopathy at first screening in persons with type 1 diabetes diagnosed under 18 years of age.Eye (London, England) · 2021Article
- A retrospective epidemiological study of type 1 diabetes mellitus in wales, UK between 2008 and 2018.International journal of population data science · 2021Article
- Pregnancy in teenagers diagnosed with type 1 diabetes mellitus in childhood: a national population-based e-cohort study.Diabetologia · 2020Article
- Using general practice clinical information system data for research: the case in Australia.International journal of population data science · 2020Article
- Educational and Health Outcomes of Children Treated for Type 1 Diabetes: Scotland-Wide Record Linkage Study of 766,047 Children.Diabetes care · 2019Article
- Association of Area Deprivation and Diabetic Ketoacidosis Readmissions: Comparative Risk Analysis of Adults vs Children With Type 1 Diabetes.The Journal of clinical endocrinology and metabolism · 2019Article
- Healthcare reimbursement costs of children with type 1 diabetes in the Netherlands, a observational nationwide study (Young Dudes-4).BMC endocrine disorders · 2018Observational
- Diabetes Technology Update: Use of Insulin Pumps and Continuous Glucose Monitoring in the Hospital.Diabetes care · 2018Review
- Management of Type 1 Diabetes in the Hospital Setting.Current diabetes reports · 2017Review
- Using routinely recorded data in the UK to assess outcomes in a randomised controlled trial: The Trials of Access.Trials · 2017Review
- Socioeconomic Deprivation, Household Education, and Employment are Associated With Increased Hospital Admissions and Poor Glycemic Control in Children With Type 1 Diabetes Mellitus.The review of diabetic studies : RDSArticle
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Authors and funding
10 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo estimate the excess in admissions associated with type1 diabetes in childhood.
designMatched-cohort study using anonymously linked hospital admission data.
settingBrecon Group Register of new cases of childhood diabetes in Wales linked to hospital admissions data within the Secure Anonymised Information Linkage Databank. POPULATION: 1577 Welsh children (aged between 0 and 15 years) from the Brecon Group Register with newly-diagnosed type-1 diabetes between 1999-2009 and 7800 population controls matched on age, sex, county, and deprivation, randomly selected from the local population.
main outcome measuresDifference in all-cause hospital admission rates, 30-days post-diagnosis until 31 May 2012, between participants and controls.
resultsChildren with type-1 diabetes were followed up for a total of 12,102 person years and were at 480% (incidence rate ratios, IRR 5.789, (95% CI 5.34 to 6.723), p<0.0001) increased risk of hospital admission in comparison to matched controls. The highest absolute excess of admission was in the age group of 0-5 years, with a 15.4% (IRR 0.846, (95% CI 0.744 to 0.965), p=0.0061) reduction in hospital admissions for every 5-year increase in age at diagnosis. A trend of increasing admission rates in lower socioeconomic status groups was also observed, but there was no evidence of a differential rate of admissions between men and women when adjusted for background risk. Those receiving outpatient care at large centres had a 16.1% (IRR 0.839, (95% CI 0.709 to 0.990), p=0.0189) reduction in hospital admissions compared with those treated at small centres.
conclusionsThere is a large excess of hospital admissions in paediatric patients with type-1 diabetes. Rates are highest in the youngest children with low socioeconomic status. Factors influencing higher admission rates in smaller centres (eg, "out of hours resources") need to be explored with the aim of targeting modifiable influences on admission rates.
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