The burden of hospitalization related to diabetes mellitus: a population-based study

Nutr Metab Cardiovasc Dis. 2012 Jul;22(7):605-12. doi: 10.1016/j.numecd.2010.10.016. Epub 2011 Feb 17.


Background and aims: To estimate the impact of diabetes and its complications, overall and in different age classes, on the likelihood of hospital admission for specific causes.

Methods and results: We carried out a record-linkage analysis of administrative registers including data on 8,940,420 citizens in 21 Local Health Authorities in Italy. Individuals with pharmacologically treated diabetes (≥2 prescriptions of antidiabetic agents during the year 2008) were paired in a 1:1 proportion with those who did not receive such drugs (controls) based on propensity-score matching. Odds Ratios (ORs) of hospitalization for macro and microvascular conditions in individuals with diabetes as compared to controls were estimated. The system identified 498,825 individuals with diabetes pharmacologically treated (prevalence of 5.6%). Prevalence of diabetes in people aged <14 years, 14-39 years, 40-65 years, and ≥65 years was 0.1%, 0.6%, 6.4%, and 18.2%, respectively. Overall, 23.9% of subjects with diabetes and 11.5% of controls had had at least a hospital admission during 12 months for the causes considered. Diabetes increased the likelihood of hospitalization by two to six times for the different causes examined. In absolute terms, diabetes was responsible for an excess of over 12,000 hospital admissions per 100,000 individuals/year.

Conclusion: Despite the availability of effective treatments to prevent or delay major complications, diabetes still places an enormous burden on both patients and the health care system. Given the continuous rise in diabetes prevalence both in middle-aged and elderly individuals, we can expect an additional, hardly sustainable increase in the demand for health care in the near future.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Benzamides / therapeutic use
  • Cost of Illness*
  • Diabetes Mellitus / drug therapy*
  • Diabetes Mellitus / epidemiology*
  • Female
  • Hospitalization
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Italy / epidemiology
  • Male
  • Metformin / therapeutic use
  • Middle Aged
  • Odds Ratio
  • Prevalence
  • Thiazolidinediones / therapeutic use
  • Treatment Outcome
  • Young Adult


  • Benzamides
  • Hypoglycemic Agents
  • Insulin
  • Thiazolidinediones
  • meglitinide
  • Metformin