Soft tissue and bone infections, urinary tract infections, stroke, and electrolyte disorder top the reasons why patients with diabetes are admitted to the hospital at greater frequency and cost compared with patients without the disease, according to a new study.
Patients with diabetes are admitted to the hospital with greater frequency and cost for soft tissue and bone infections, urinary tract infections, stroke, and electrolyte disorders than those without the disease, a new study showed.
The findings prompted researchers to call for strategies to better treat those conditions in these patients.
In a study published by CMAJ Open, researchers reviewed data from 150,499 hospital admissions between 2010 and 2015 at 7 Toronto hospitals; more than one-quarter of patients had diabetes.
Compared with patients without diabetes, hospital admissions because of soft tissue and bone infections were more frequent (2.5% v. 1.9%; prevalence ratio [PR], 1.28; 95% CI, 1.19-1.37) and costly in Canadian dollars ($8794 v. $5845; cost ratio [CR] 1.50; 95% CI, 1.37-1.65) among patients with diabetes.
That set of infections was followed by urinary tract infections (PR, 1.16; 95% CI, 1.11–1.22; CR, 1.23; 95% CI, 1.17-1.29); stroke (PR, 1.13; 95% CI, 1.07–1.19; CR, 1.19; 95% CI, 1.14–1.25); and electrolyte disorders (PR, 1.11; 95% CI, 1.03-1.20; CR, 1.20; 95% CI, 1.08–1.34).
Nearly 1 in 10 individuals in the United States and Canada are diagnosed with diabetes, a figure that is projected to increase to 1 in 5 by 2050, the study noted. Diabetes cost Canada $2.18 billion (US$ 1.8 billion) in 2008 in hospital admissions, physician care, and medication, with an additional cost from new cases estimated at $15.36 billion in 2022. One-fourth of all US health care expenditures in 2017 were incurred by those with diabetes.
Soft tissue and bone infections have not received the attention they should, the authors said. For decades, lower-extremity amputations for diabetes patients had been falling, but a 2017 meta-analysis showed amputations beginning to rise again. The authors recommended preventive measures including regular foot examinations, debridement, mechanical offloading devices, and visits to podiatrists.
Regarding urinary tract infections, the authors called for a focus on asymptomatic bacteriuria. There also needs to be better understanding of the safety of sodium-glucose co-transporter-2 inhibitors, which are used in diabetes treatment, on urinary tract infections.
Individuals with diabetes are twice as likely to have a stroke than those without the disease. Adoption in recent years of strategies to treat cardiac conditions have reduced rates of stroke overall significantly, but admissions remain more common among diabetes patients, the researchers said.
In addition, the study found acute renal failure (PR, 2.02; 95% CI, 1.87-2.17); heart failure (PR, 1.88; 95% CI, 1.80-1.96); soft tissue and bone infections (PR, 1.28; 95% CI, 1.19-1.37); sepsis (PR, 1.22; 95% CI, 1.14-1.31; urinary tract infections (PR, 1.16; 95% CI, 1.11-1.22); delirium (PR, 1.15; 95% CI 1.08-1.23); stroke (PR, 1.13; 95% CI, 1.07-1.19); and electrolyte disorders (PR, 1.11; 95% CI, 1.03-1.20) were the more common reasons for hospital admission among patients with diabetes compared with those without.
However, acute renal failure, heart failure, sepsis, and delirium were not associated with a higher cost.
For the most common causes of admission in the diabetes population, the median costs were $12,916 for delirium, $10,722 for sepsis, $8794 for soft tissue and bone infections, $8270 for stroke, $6821 for heart failure, $6301 for acute renal failure, $6278 for chronic obstructive pulmonary disease, $6183 for pneumonia, $5442 for urinary tract infection and $4422 for electrolyte disorders.
Overall, acute inpatient hospital admissions account for more than half of all healthcare costs related to diabetes. Diabetes itself a rarely a reason for admission; comorbid conditions are the drivers of admissions.
Reference
Choi J, Booth G, Hung, HY. Association of diabetes with frequency and cost of hospital admissions: a retrospective cohort study. CMAJ Open. 2021;9(2): E406-512. doi:10.9778/cmajo.20190213
Roflumilast Cream 0.05% Durable, Safe for Younger Pediatric Patients
August 15th 2025The INTEGUMENT-OLE study is an open-label extension analysis that followed a primary investigation from the phase 3 INTEGUMENT-PED trial, which investigated the efficacy and safety of once-daily roflumilast cream 0.05% for atopic dermatitis in children aged 2 to 5 years.
Read More
PCPs Have Unique Opportunity to Detect, Manage CKD
August 14th 2025As the prevalence of chronic kidney disease (CKD) continues to rise, empowering primary care providers (PCPs) with the tools, training, and collaborative frameworks needed for optimal management is a public health priority, emphasize the researchers.
Read More
Polypharmacy Common in Rheumatoid Arthritis, Driving Risk of Serious Drug Interactions
August 13th 2025More than 8 in 10 patients with rheumatoid arthritis were taking 5 or more medications at once, a practice linked to older age, multiple comorbidities, and more than 2000 potential drug-to-drug interactions.
Read More