| Objective: To collect the medical records of patients hospitalized in the Lanzhou University Second Hospital from January 2013 to December 2021 and diagnosed with type 2 diabetes(T2DM)in the discharge diagnosis.To describe the demographic and clinical medical record characteristics of T2 DM inpatients in the past eight years.To analyze the distribution of hospitalization expenses of T2 DM inpatients,the composition and change trend of chronic complications,and the use of oral hypoglycemic drugs and insulin injection during hospitalization.To compare the differences in T2 DM related complications among different ethnic groups(Han,Hui,Dongxiang,and Tibetan),and explore the main influencing factors for multiple hospitalizations of T2 DM inpatients.To provide data support for developing accurate diabetes intervention measures and medical care plans,reducing the occurrence and progress of chronic complications,and reducing the burden of disease.Methods: This study is a single center retrospective study,with 109056 T2 DM patients in the discharge diagnosis who visited Lanzhou University Second Hospital from January 2013 to December 2021 as the study subjects.According to the number of hospitalizations,they were divided into patients who were hospitalized once(n=74888),patients who were repeatedly hospitalized(n=34168),and patients who were rehospitalized within 30 days(n=4352).Demographic data,clinical medical records,and relevant medical information of all patients were collected.Describe the etiological composition of hospitalized patients with T2 DM.Describe the clinical characteristics,composition and trend of chronic complications or comorbidities of T2 DM inpatients,and analyze the main influencing factors of multiple hospitalizations and rehospitalizations within 30 days of T2 DM patients using logistic regression.Statistical analysis of the above data was conducted using SPSS26.0,Graph-pad Prism8.0 mapping,and Microsoft Office Excel 2010 mapping and tabulation.Results: 1.Current situation of T2 DM inpatients: From January 2013 to December 2021,there were 74888 T2 DM inpatients with only one hospitalization record,with an overall trend of annual growth in the number of inpatients,and the number of male patients was higher than female patients(61.8% vs 38.2%).34168 patients were repeatedly admitted,with a total rehospitalization rate of 31.3%.4352 inpatients with T2 DM were readmitted within 30 days,accounting for 4.0% of the total.2.Age and ethnic distribution of T2 DM inpatients: The majority of T2 DM inpatients are elderly(≥ 60 years old,57.2%),with an average age of(62.1 ± 11.7)years old.The average age of women(63.7 ± 11.4 years old)is higher than men(61.5 ± 11.7years old)(P<0.05).The ethnic distribution is dominated by the Han nationality(89.2%).Among the minority nationalities,the Hui nationality(7.1%)is the majority,followed by the Dongxiang nationality(1.8%)and the Tibetan nationality(1.2%).3.Complications or comorbidities of T2 DM inpatients: 80.2% of T2 DM inpatients have diabetes related complications or comorbidities.The top nine are hypertension(52.3%),diabetes peripheral neuropathy(25.5%),diabetes nephropathy(24.3%),cerebrovascular disease(16.8%),dyslipidemia(16.0%),heart failure(15.5%),diabetes peripheral vascular disease(15.4%),coronary heart disease(10.9%)Diabetes retinopathy(10.0%),diabetes foot disease(0.6%).The prevalence of complications or comorbidities of T2 DM among various ethnic groups(Han,Hui,Dongxiang,and Tibetan)is not significantly different from the general population,and hypertension is still the most common complication.4.The duration of diabetes,length of stay and hospitalization expenses of T2 DM inpatients: When the duration of diabetes of T2 DM inpatients is about 10 years,the proportion of patients suffering from complications of diabetes or comorbidities is the highest(43.1%).Patients with complications or comorbidities had longer hospital stay(10.5 ± 7.8 vs 10.2 ± 8.1 days)and higher medical costs(18276.2 ± 24181.2 vs 16124.7± 21598.5 yuan)than patients with T2 DM alone(P<0.05).5.Clinical characteristics of T2 DM inpatients with complications or comorbidities: The average fasting blood glucose(FPG)of T2 DM inpatients in males is higher than that in females(10.3 ± 5.4 vs 10.1 ± 5.1 mmol/L)(P<0.05),and the FPG of patients with abnormal low density lipoprotein(LDL)is higher than that patients with normal LDL(10.6 ± 5.4 vs 9.9 ± 5.2 mmol/L)(P<0.05),and the FPG of patients with abnormal TC is higher than that patients with normal TC(10.9 ± 5.7 vs 9.8 ± 5.1mmol/L)(P<0.05).The FPG of patients with abnormal TG was higher than that patients with normal TG(11.1 ± 5.7 vs 9.4 ± 4.7 mmol/L)(P<0.05).FPG values were positively correlated with TC,TG,LDL,serum potassium ions,and total protein,while negatively correlated with UA,systolic blood pressure(SDP),diastolic blood pressure(DBP),albumin,and serum creatinine.6.Clinical medication for T2 DM inpatients: 40.0% of T2 DM inpatients use oral hypoglycemic drugs during hospitalization,and the most commonly used oral hypoglycemic drugs are α Glycosidase inhibitors(27.3%)and biguanides(21.6%).38.2%of inpatients use insulin injection,with the highest proportion of premixed insulin injection(49.6%),followed by long-acting insulin injection(11.6%)and short-acting or fast-acting insulin injection(6.9%).The proportion of patients treated with oral drugs combined with insulin hypoglycemic therapy is 15%.7.Influential factors of repeated hospitalization of T2 DM inpatients: age,gender,duration of diabetes,increase of serum potassium and LDL and TG,coronary heart disease,heart failure,diabetes retinopathy,diabetes nephropathy and hypertension of inpatients with T2 DM diagnosis are important influencing factors of repeated hospitalization.Conclusions: Hospitalized patients with T2 DM diagnosis are mainly elderly men,most of whom have diabetes related complications or comorbidities,and hypertension is the most common.FPG of hospitalized patients is significantly related to TG,TC and LDL.Strengthening the standardized management of blood sugar,blood pressure and blood lipid,and popularizing the education of diabetes and its complications among hospitalized patients are of great significance to reduce the occurrence and progress of chronic complications and the disease burden of T2 DM.Gender,age,course of diabetes and whether there are complications or comorbidities are important influencing factors for repeated hospitalization.There are a wide variety of complications or comorbidities related to T2 DM,covering multiple disciplines and systems,which are prone to misdiagnosis or missed diagnosis in clinical practice.Targeted screening of diabetes,improving the diagnosis rate and standardized treatment are particularly important to reduce the repeated hospitalization of T2 DM patients and the protection of corresponding target organs. |
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