Report: Blood sugar-related hospital visits more frequent for younger adults with diabetes

Research by the Minnesota Department of Health (MDH) has found that younger adults with diabetes are more likely to have high blood sugar levels than older adults. Younger adults, those 18 to 44 years old, were also more likely to land in the hospital due to out-of-control blood sugar levels.

Hospitalizations due to out-of-control blood sugars occurred three to five times more frequently among young adults with diabetes than older adults living with diabetes.

In Minnesota, about one in 10 adults with diabetes is a young adult. However, because diabetes more commonly affects older adults, most reports about diabetes examine the total population and reflect the experiences of older adults.

"These findings show we need to tailor our care and outreach to address the needs of younger adults with diabetes," said Minnesota Commissioner of Health Jan Malcolm. "These people have long lives ahead of them and it is important to ensure that diabetes is managed well so they can live those years in good health."

Most hospitalizations for out-of-control blood sugars were for diabetic ketoacidosis, a potentially life-threatening but avoidable condition. The Centers for Disease Control and Prevention reports that diabetic ketoacidosis is on the rise, especially among adults younger than 45.

On average, 18- to 44-year-olds were more likely to miss their blood sugar targets compared to older adults. Only about four out of 10 young adults met their targets for blood sugar control, compared to nearly eight of 10 older adults meeting their targets.

The research team found differences that might contribute to higher blood glucose levels for young adults:

• Compared to older adults, 18- to 44-year-olds with diabetes were slightly less likely to report having their blood sugar levels checked in the last year and to have a primary care provider who can help to manage diabetes.
• Younger adults had higher rates of depression and hospitalization for mental health conditions, according to the study.
• Other factors such as having continuous insurance coverage, affordability of health care costs, cost of insulin and other medications, and changing life demands and responsibilities as one moves from adolescence to adulthood may also play a part, but the study could not address these issues.

Some targeted actions for young adults could include addressing barriers to regular blood sugar testing and better integration of mental health care and diabetes management.

Hospitalization is only one of several potential negative outcomes for out-of-control blood sugars. Long-term exposure to high blood sugar can cause kidney, eye, and nervous system damage. Among younger adults, high blood sugar can contribute to infertility and, in women, uncontrolled blood sugar can be associated with poor pregnancy outcomes like birth defects, high birthweights, and stillbirth.

The research used 2013-2015 data from the Behavioral Risk Factor Surveillance System telephone survey, data collected by Minnesota Community Measurement for statewide quality reporting, and Minnesota hospital discharge data from the Minnesota Hospital Association and other neighboring states.  The findings are published in Preventing Chronic Disease, a medical journal from the Centers for Disease Control and Prevention. See Diabetes Treatment, Control, and Hospitalization Among Adults Aged 18 to 44 in Minnesota, 2013–2015.