Background: A diversification of diabetes-related complications has been observed due, in part, to declines in cardiovascular mortality and increases in time spent living with diabetes. We examined leading causes of excess hospitalizations among people with vs. without diabetes.

Methods: We used the 2019 National Inpatient Sample (numerator) and the 2019 Behavioral Risk Factor Surveillance Survey (denominator), weighted to reflect the U.S. population, to estimate rates of cause-specific hospitalizations in adults (≥18 years) with and without diabetes defined by ICD codes (numerator) and self-report (denominator). Annual age-standardized hospitalization rates were determined using three-digit ICD-10 codes, with excess risk and rate ratios reported. We grouped the top ten causes of excess hospitalizations as 1) traditional (e.g., vascular diseases); 2) emerging (e.g., liver disease); or 3) other complications.

Results: Americans with diabetes are at increased risk of hospitalization for most conditions, ranging from a 3% [rate ratio (RR): (1.00-1.05)] to a 9-fold increased risk [RR: 9.00 (8.96-9.04)]. The major causes for excess hospitalization in people with vs. without diabetes, according to traditional, emerging, or other complications are reported in Table 1.

Conclusions: The conditions responsible for excess hospitalizations in people with diabetes are more diverse than previously recognized.


J.L. Harding: None. T.S. Uppal: None. D. Tomic: None. M.K. Ali: Research Support; Merck & Co., Inc. Advisory Panel; Bayer Inc., Eli Lilly and Company. D.J. Magliano: None.

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