Scandinavian journal of primary health care · 2025
Association of glycemic control and chronic kidney disease with hospitalization in type 2 diabetes in a cross-sectional study in Region Halland.
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Magamba Bertin, Miao Jonasson Junmei, Agvall Björn
Аннотация
AIMS: To examine the separate associations of glycemic control and chronic kidney disease with hospitalization days over one year in patients with type 2 diabetes (T2D).
MATERIALS AND METHODS: A cross-sectional study using retrospective data on T2D patients in Region Halland, Sweden, during 2020. Data from the Region Halland database included hospitalizations, emergency visits, primary care encounters, glycemic control, estimated glomerular filtration rate (eGFR), comorbidities, pharmacotherapy and healthcare encounters. Negative binomial regression was used to assess associations with healthcare utilization.
RESULTS: A total of 12,689 patients participated, with an average age of 66.0 years (67.1 years for women and 65.2 years for men, p = 0.010). Higher glycated hemoglobin (HbA1c) and elevated blood glucose levels were associated with increased hospitalization days. Relative risks (RRs) for hospitalization days were higher for HbA1c 52-70 mmol/mol (RR 1.08, 95% CI 1.01-1.15) and >70 mmol/mol (RR 1.24, 95% CI 1.12-1.37). Elevated blood glucose levels ≥7.8 mmol/L had an RR of 1.17 (95% CI 1.04-1.32), while <7.8 mmol/L had an RR of 0.85 (95% CI 0.76-0.96). Patients with an eGFR between 30 and 60 mL/min had a RR of hospitalization of 1.35 (95% CI 1.26-1.44) compared to those with an eGFR >60 mL/min. For patients with an eGFR <30 mL/min, the RR of hospitalization was 3.36 (95% CI 3.00-3.77).
CONCLUSIONS: Both poor glycemic control and decreased kidney function were associated with higher hospitalization rates in T2D patients. These findings emphasize the need for effective management of glycemic control and renal function to reduce the healthcare burden in this patient population.
MATERIALS AND METHODS: A cross-sectional study using retrospective data on T2D patients in Region Halland, Sweden, during 2020. Data from the Region Halland database included hospitalizations, emergency visits, primary care encounters, glycemic control, estimated glomerular filtration rate (eGFR), comorbidities, pharmacotherapy and healthcare encounters. Negative binomial regression was used to assess associations with healthcare utilization.
RESULTS: A total of 12,689 patients participated, with an average age of 66.0 years (67.1 years for women and 65.2 years for men, p = 0.010). Higher glycated hemoglobin (HbA1c) and elevated blood glucose levels were associated with increased hospitalization days. Relative risks (RRs) for hospitalization days were higher for HbA1c 52-70 mmol/mol (RR 1.08, 95% CI 1.01-1.15) and >70 mmol/mol (RR 1.24, 95% CI 1.12-1.37). Elevated blood glucose levels ≥7.8 mmol/L had an RR of 1.17 (95% CI 1.04-1.32), while <7.8 mmol/L had an RR of 0.85 (95% CI 0.76-0.96). Patients with an eGFR between 30 and 60 mL/min had a RR of hospitalization of 1.35 (95% CI 1.26-1.44) compared to those with an eGFR >60 mL/min. For patients with an eGFR <30 mL/min, the RR of hospitalization was 3.36 (95% CI 3.00-3.77).
CONCLUSIONS: Both poor glycemic control and decreased kidney function were associated with higher hospitalization rates in T2D patients. These findings emphasize the need for effective management of glycemic control and renal function to reduce the healthcare burden in this patient population.