Proportion of Canadian adults with unreported type 2 diabetes who experience a related hospitalization: Results from Canadian Community Health Survey and Discharge Abstract Database linkage
Authors: Aini Khan
Background: People with type 2 diabetes (T2D) may go undiagnosed and subsequently be hospitalized with T2D. Objective: Determine the percentage of Canadians, with unreported T2D, who experience a T2D hospitalization Methods: Using linked dataset, respondents who reported no diabetes in the Canadian Community Health Survey, were followed in the Discharge Abstract Database for T2D hospitalization event. Results: 0.56% of men and 0.44% of women, who reported no diabetes, were hospitalized with T2D. Older Age, higher BMI and worse self-reported health increased T2D hospitalization in both men and women. In women, drinking alcohol, smoking tobacco and lower physical activity were associated with an increase in T2D hospitalization. Conclusion: Significant proportion of Canadians experience a T2D hospitalization when self-reporting undiagnosed diabetes. Potential risk factors were identified; however, further research needs to focus on understanding these relationships. Summary for Lay Audience Type 2 diabetes (T2D) is a growing public health concern and early detection and management is key to controlling the pandemic. Since T2D can be present for a long time before patients start experiencing symptoms, some Canadians may be unaware of having the condition. These individuals may eventually present to the hospital with related complications. The objective of this thesis was to determine what percentage of Canadians who reported not having T2D, might actually have the disease and end up in the hospital with related condition. This thesis assessed whether the percentage of Canadians who reported no diabetes but were hospitalized with T2D related condition changed over time. Lastly, this thesis looked at potential factors that might increase or decrease T2D hospitalization risk among this group. This thesis utilized a national self-reported survey (Canadian Community Health Survey [CCHS]) and national hospitalization records (Discharge Abstract Database [DAD]). Canadians who responded to the CCHS and reported no previous T2D diagnosis were followed in the DAD to see if they experienced a related hospitalization. This thesis found that 0.56% of men and 0.44% of women were hospitalized with T2D even though they reported no diabetes. This percentage increased with each year for men between 2000 to 2009 from 0.41% to 0.71%. With increasing age, higher BMI and self-reported poor health, Canadians were more likely to be hospitalized with T2D. In Canadian women, alcohol drinking prevented T2D hospitalization, while smoking tobacco, and lower physical activity were associated with increase in T2D hospitalization. Identifying T2D early could be an effective strategy to minimize the long-term impacts of the disease. Future research should focus on linking other administrative datasets, such as physician billing or laboratory results to get a full picture of this problem.
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