Type 2 diagnoses propel diabetes epidemic

WASHINGTON —Diabetes quickly has grown into one of the top disease epidemics in the United States, with the American Diabetes Association estimating it to affect close to 24 million Americans. Growth mostly has occurred among those with Type 2 diabetes.

A report by the Agency for Healthcare Research and Quality helped show what the epidemic looks like on the ground. According to the report, released last month, there were more than 7.7 million hospital stays for patients with diabetes in 2008, resulting in $83 billion in hospital costs, or 23% of total hospital costs.

Class and geography had a lot to do with hospitalization rates, according to the report. When broken down by ZIP code, rates were higher in low-income areas than in high-income areas, with 3,232 hospitalizations per 100,000 people in the lowest-income areas, compared with 1,762 per 100,000 people in those areas with the highest incomes.

Among U.S. regions, the South had the highest rates, with 2,829 per 100,000 people hospitalized, while the West had the lowest, with 1,866 per 100,000 hospitalized. Not surprisingly, according to the Centers for Disease Control and Prevention, the South and West also have the highest and lowest rates of obesity, respectively, a major factor in the rise of Type 2 diabetes. Eight-of-the-9 states with obesity rates more than 30% as of 2009 are in the South, while 9-of-the-17 states with rates less than 25% are in the West, including Colorado, the only state in which fewer than 20% of residents are obese.

Top 10 most common principal reasons for hospitalization among patients with diabetes in 2008


*Based on all-listed diagnoses; includes % of total hospitalizations for patients with diabetes†Based on records with diabetes as a secondary diagnosis (e.g., for hospitalizations with a principal diagnosis of congestive heart failure, 41.6% have diabetes as a coexisting condition) Source: AHRQ, Center for Delivery, Organization and Markets, Healthcare Cost and Utilization Project, Nationwide Inpatient Sample, 2008
RANK PRINCIPAL DIAGNOSIS #OF HOSPITAL STAYS AMONG PATIENTS WITH DIABETES* %OF HOSPITAL STAYS WITH DIABETES AS A COEXISTING CONDITION†
1 Diabetes 519,522 (6.7%) NA
2 Congestive heart failure (nonhypertensive) 424,147 (5.5%) 41.6%
3 Coronary atherosclerosis (hardening of the arteries) 346,054 (4.5%) 37.7
4 Pneumonia 290,709 (3.8%) 25.1
5 Septicemia 224,842 (2.9%) 28.4
6 Acute myocardial infarction (heart attack) 220,760 (2.9%) 34.2
7 Chronic obstructive pulmonary disease and bronchiectasis 219,743 (2.8%) 30.7
8 Nonspecific chest pain 212,706 (2.8%) 29.3
9 Cardiac dysrhythmias 196,293 (2.5%) 24.6
10 Complication of device, implant or graft 194,516 (2.5%) 28.4