Statistics On The Hospitalizations For Diabetes As Any-listed Diagnosis In West China Hospital, 1955-2002

Objectives: To estimate the number of hospital discharges with diabetes as any-listed diagnosis in all patients hospitalized in WCH, 1955-2002, and analyze the causes of hospitalizations, the frequency of acute and chronic diabetic complications, insulin and oral medication use, and causes of death. We hope these data are helpful to increase recognition of the disease and evaluate progress in disease prevention and control in our country. Objects and Methods: To retrospectively analyze the clinical and laboratory data on hospitalizations with diabetes in WCH from 1955 through 2002,and obtain the diabetics medical records often years by selecting a whole year's diabetics medical records every five years.Results: From 1955 through 2002 , the proportion of hospitalizations with diabetes increased more than 16.4 folds (from 15.86 per ten thousand in 1955 to 261.5 per ten thousand in 2002 ) during this period, the most among persons with diabetes aged 65 years and older (from 6.7% to 46.1%). The major cause of hospitalizations with diabetes were infection in 47.1% in 1955.And it changed to acute diabetic complications in 34.5% in 1975. In 1996 and 2002, the major cause of hospitalizations was chronic diabeticcomplications in 24.0% and 28.6%. Between 1960 and 2002, the prevalence of acute diabetic complications decreased by about 20% (from 20% to 16%). The prevalence of chronic diabetic complications increased by 898%, from 6.7% in 1955 to 66.9% in 2002. From 1970 through 2002, the prevalence of microvascular disease increased 297% (from 10.8% to 42.9%) .In 2002, the prevalence of hypertension was 55.5%, and 42.8% for dyslipidemia.Risk factors associated with chronic complications of type 2 diabetes (T2DM) were age(odds ratio [OR] :3.798), duration of diabetes (OR :2.644), hyperchotesterolemia (OR: 1.746) and high systolic blood pressure(OR: 1.644). Between 1955 and 2002, the major causes of death in diabetic hospitalizations were cardiovascular and cerebrovascular disease in 24.6%, chronic renal failure in 23.8% ,infection in 19.2% and acute diabetic complications in 8.5%.Conclusion: The following are the changes of clinic data of diabetic hospitalizations in WCH in recent fifty years:The proportion of diabetic hospitalizations to all hospitalizations increased. The main cause of hospitalization changed from infection, hyperglycemia and acute diabetic complications in 1955-1990 to chronic diabetic complication in recent ten years. The prevalence of acute diabetic complication decreased but that of chronic diabetic complication increased, especially the prevalence of microvascular disease increased. And the prevalence of hypertension or dyslipidemia also rose. Main risk factors for chronic complications of T2DM were age, duration of diabetes, hyperchotesterolemia and high systolic blood pressure. Medicationadministration record showed single medication of insulin still prevails. The mortality decreased while the age of inpatients dead increased. Main causes of death were cardiovascular and cerebrovascular disease, chronic renal failure and infection. The proportion of chronic renal failure rose and that of infection and acute diabetic complication decreased.