Alcohol-Related Hospitalizations Among Adolescents and Young Adults with Type 1 Diabetes in Spain, 2016−2023
Abstract
1. Introduction
2. Materials and Methods
2.1. Statistical Analysis
2.2. Ethical Aspects
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
ER | emergency room |
T1D | type 1 diabetes |
DKA | diabetic ketoacidosis |
ARHAs | alcohol-related hospital admissions |
SHDD | Spanish Hospital Discharge Database |
SMH | Spanish Ministry of Health |
ICU | intensive care unit |
ICD-10 | International Classification of Diseases, Tenth Revision |
T2D | type 2 diabetes |
LOHS | length of hospital stay |
IHM | in-hospital mortality |
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2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | p for Trend | Total | ||
---|---|---|---|---|---|---|---|---|---|---|---|
N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | |||
Number of T1D hospital admissions | 4806 | 4718 | 4938 | 5210 | 4596 | 4860 | 4964 | 4999 | NA | 39,091 | |
Number of ARHAs | 119 (2.48) | 144 (3.05) | 139 (2.81) | 163 (3.13) | 150 (3.26) | 171 (3.52) | 211 (4.25) | 177 (3.54) | <0.001 | 1274 (3.26) | |
Gender | Male | 93 (78.15) | 116 (80.56) | 112 (80.58) | 126 (77.3) | 115 (76.67) | 121 (70.76) | 142 (67.3) | 119 (67.23) | 0.008 | 944 (74.10) |
Female | 26 (21.85) | 28 (19.44) | 27 (19.42) | 37 (22.7) | 35 (23.33) | 50 (29.24) | 69 (32.7) | 58 (32.77) | 330 (25.90) | ||
Age in years. Mean (SD) | 27.87 (5.76) | 28.1 (5.73) | 26.66 (5.66) | 26.82 (6.33) | 27.27 (6.19) | 27.01 (5.81) | 27.41 (5.99) | 26.78 (5.95) | 0.338 | 27.22 (5.95) | |
Age groups | 12–17 years | 6 (5.04) | 6 (4.17) | 8 (5.76) | 12 (7.36) | 9 (6) | 8 (4.68) | 16 (7.58) | 13 (7.34) | 0.265 | 78 (6.12) |
18–23 years | 24 (20.17) | 30 (20.83) | 33 (23.74) | 44 (26.99) | 44 (29.33) | 44 (25.73) | 37 (17.54) | 44 (24.86) | 300 (23.55) | ||
24–29 years | 34 (28.57) | 38 (26.39) | 46 (33.09) | 35 (21.47) | 29 (19.33) | 50 (29.24) | 70 (33.18) | 50 (28.25) | 352 (27.63) | ||
30–35 years | 55 (46.22) | 70 (48.61) | 52 (37.41) | 72 (44.17) | 68 (45.33) | 69 (40.35) | 88 (41.71) | 70 (39.55) | 544 (42.7) | ||
Weekend admissions | 34 (28.57) | 34 (23.61) | 40 (28.78) | 48 (29.45) | 40 (26.67) | 49 (28.65) | 51 (24.17) | 37 (20.90) | 0.565 | 333 (26.14) | |
Admission to ICU | 16 (13.45) | 21 (14.58) | 43 (30.94) | 32 (19.63) | 32 (21.33) | 32 (18.71) | 44 (20.85) | 45 (25.42) | 0.009 | 265 (20.80) | |
LOHS. Median (IQR) | 4 (4) | 4 (4) | 3 (3) | 3 (4) | 4 (4) | 4 (4) | 4 (5) | 3 (4) | 0.213 | 4 (4) | |
IHM | 0 (0) | 0 (0) | 1 (0.72) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | NA | 1 (0.08) |
2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | p | Total | |
---|---|---|---|---|---|---|---|---|---|---|
N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | ||
Diabetic ketoacidosis | 72 (60.5) | 79 (54.86) | 100 (71.94) | 95 (58.28) | 94 (62.67) | 107 (62.57) | 117 (55.45) | 107 (60.45) | 0.079 | 771 (60.52) |
Hypoglycemia | 6 (5.04) | 11 (7.64) | 5 (3.60) | 7 (4.29) | 10 (6.67) | 8 (4.68) | 7 (3.32) | 6 (3.39) | 0.527 | 60 (4.71) |
Mental disorders | 15 (12.61) | 23 (15.97) | 16 (11.51) | 21 (12.88) | 27 (18) | 26 (15.2) | 37 (17.54) | 32 (18.08) | 0.584 | 197 (15.46) |
Drug use | 54 (45.38) | 68 (47.22) | 71 (51.08) | 68 (41.72) | 81 (54) | 92 (53.8) | 112 (53.08) | 87 (49.15) | 0.271 | 633 (49.69) |
Tobacco use | 72 (60.5) | 95 (65.97) | 93 (66.91) | 100 (61.35) | 104 (69.33) | 110 (64.33) | 138 (65.4) | 93 (52.54) | 0.061 | 805 (63.19) |
External causes of morbidity and mortality | 13 (10.92) | 15 (10.42) | 5 (3.6) | 14 (8.59) | 23 (15.33) | 22 (12.87) | 26 (12.32) | 23 (12.99) | 0.065 | 141 (11.07) |
COVID-19 | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 6 (3.51) | 15 (7.11) | 4 (2.26) | <0.001 | 25 (3.53) * |
Male | Female | p | ||
---|---|---|---|---|
N (%) | N (%) | |||
Number of T1D hospital admissions | 18,533 | 20,558 | NA | |
Number of ARHAs | 944 (5.09) | 330 (1.61) | <0.001 | |
Age | Mean (SD) | 27.88 (5.66) | 25.31 (6.34) | <0.001 |
Age | 12–17 years | 43 (4.56) | 35 (10.61) | <0.001 |
18–23 years | 191 (20.23) | 109 (33.03) | ||
24–29 years | 262 (27.75) | 90 (27.27) | ||
30–35 years | 448 (47.46) | 96 (29.09) | ||
Weekend | 242 (25.64) | 91 (27.58) | 0.490 | |
Admission to ICU | 181 (19.17) | 84 (25.45) | 0.016 | |
LOHS. Median (IQR) | 3 (4) | 4 (4) | 0.342 | |
IHM | 1 (0.11) | 0 (0) | 0.554 | |
Diabetic ketoacidosis | 552 (58.47) | 219 (66.36) | 0.012 | |
Hypoglycemia | 47 (4.98) | 13 (3.94) | 0.443 | |
Mental disorders | 113 (11.97) | 84 (25.45) | <0.001 | |
Drug use | 492 (52.12) | 141 (42.73) | 0.003 | |
Tobacco use | 601 (63.67) | 204 (61.82) | 0.549 | |
External causes of morbidity and mortality | 89 (9.43) | 52 (15.76) | 0.002 | |
COVID-19 | 20 (2.12) | 5 (1.52) | 0.496 |
Male | Female | Both Gender | ||
---|---|---|---|---|
Study Variable | Categories | OR (95% CI) | OR (95% CI) | OR (95% CI) |
Age groups | 12–17 years | Reference | Reference | Reference |
18–23 years | 3.12 (2.21–4.42) | 1.9 (1.27–2.85) | 2.52 (1.93–3.27) | |
24–29 years | 4.08 (2.9–5.74) | 1.32 (0.86–2.01) | 2.73 (2.1–3.54) | |
30–35 years | 5.43 (3.9–7.56) | 1.26 (0.83–1.92) | 3.37 (2.61–4.35) | |
Weekend | 1.13 (0.96–1.34) | 1.32 (1.02–1.71) | 1.18 (1.03–1.36) | |
Diabetic ketoacidosis | 1.63 (1.4–1.89) | 2.52 (1.97–3.22) | 1.84 (1.62–2.09) | |
Hypoglycemia | 1.74 (1.24–2.44) | 1.2 (0.67–2.17) | 1.55 (1.16–2.07) | |
Mental disorders | 1.22 (0.94–1.57) | 1.28 (0.9–1.8) | 1.25 (1.02–1.53) | |
Drug use | 6.15 (5.27–7.18) | 70.1 (5.32–9.21) | 6.40 (5.59–7.33) | |
Tobacco use | 2.71 (2.32–3.18) | 4.46 (3.41–5.83) | 3.16 (2.76–3.62) | |
Year of admission | 2016 | Reference | Reference | Reference |
2017 | 1.15 (0.85–1.54) | 0.99 (0.57–1.73) | 1.11 (0.86–1.44) | |
2018 | 1.01 (0.75–1.36) | 0.86 (0.49–1.51) | 0.97 (0.75–1.27) | |
2019 | 1.06 (0.79–1.43) | 1.24 (0.74–2.09) | 1.09 (0.85–1.41) | |
2020 | 1.1 (0.82–1.49) | 1.17 (0.68–1.98) | 1.11 (0.85–1.44) | |
2021 | 1.06 (0.78–1.42) | 1.64 (1–2.7) | 1.18 (0.92–1.52) | |
2022 | 1.14 (0.85–1.53) | 2.14 (1.33–3.45) | 1.36 (1.06–1.74) | |
2023 | 0.98 (0.73–1.33) | 1.92 (1.18–3.13) | 1.18 (0.92–1.52) | |
Gender | Female | NA | NA | Reference |
Male | NA | NA | 2.46 (2.15–2.82) |
Male | Female | Both Gender | ||
---|---|---|---|---|
Study Variable | Categories | OR (95% CI) | OR (95% CI) | OR (95% CI) |
Age groups | 12–17 years | Reference | Reference | Reference |
18–23 years | 0.7 (0.31–1.61) | 1.65 (0.57–4.73) | 0.92 (0.49–1.73) | |
24–29 years | 0.89 (0.4–1.99) | 1.72 (0.58–5.11) | 1.15 (0.61–2.17) | |
30–35 years | 0.7 (0.32–1.53) | 3.11 (0.96–9.32) | 1.08 (0.58–2.01) | |
Diabetic ketoacidosis | 4.91 (3.12–7.72) | 8.47 (3.61–19.86) | 5.59 (3.78–8.26) | |
Hypoglycemia | 4.11 (2–8.47) | 0.47 (0.05–4.83) | 3.28 (1.68–6.4) | |
Drug use | 1.52 (1.25–2.17) | 1.78 (1.12–2.42) | 1.64 (1.39–1.96) | |
Year of admission | 2016 | Reference | Reference | Reference |
2017 | 1.25 (0.54–2.87) | 1.09 (0.23–5.25) | 1.24 (0.6–2.56) | |
2018 | 2.9 (1.36–6.19) | 2.89 (0.63–13.36) | 2.86 (1.47–5.58) | |
2019 | 1.78 (0.81–3.9) | 1.59 (0.35–7.19) | 1.74 (0.88–3.43) | |
2020 | 1.85 (0.84–4.06) | 2.06 (0.45–9.41) | 1.87 (0.95–3.71) | |
2021 | 1.44 (0.64–3.22) | 1.58 (0.38–6.53) | 1.45 (0.73–2.85) | |
2022 | 1.9 (0.87–4.12) | 1.71 (0.43–6.81) | 1.76 (0.91–3.39) | |
2023 | 1.72 (0.78–3.84) | 3.87 (1.03–15.03) | 2.08 (1.07–4.09) | |
Gender | Male | NA | NA | Reference |
Female | NA | NA | 1.39 (1.02–1.90) |
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Jiménez-Sierra, L.; López-de-Andres, A.; Hernández-Barrera, V.; Jiménez-Garcia, R.; Carabantes-Alarcon, D.; Bodas-Pinedo, A.; Labajo-Gonzalez, E.; Zamorano-León, J.J. Alcohol-Related Hospitalizations Among Adolescents and Young Adults with Type 1 Diabetes in Spain, 2016−2023. J. Clin. Med. 2025, 14, 4053. https://doi.org/10.3390/jcm14124053
Jiménez-Sierra L, López-de-Andres A, Hernández-Barrera V, Jiménez-Garcia R, Carabantes-Alarcon D, Bodas-Pinedo A, Labajo-Gonzalez E, Zamorano-León JJ. Alcohol-Related Hospitalizations Among Adolescents and Young Adults with Type 1 Diabetes in Spain, 2016−2023. Journal of Clinical Medicine. 2025; 14(12):4053. https://doi.org/10.3390/jcm14124053
Chicago/Turabian StyleJiménez-Sierra, Lucia, Ana López-de-Andres, Valentín Hernández-Barrera, Rodrigo Jiménez-Garcia, David Carabantes-Alarcon, Andrés Bodas-Pinedo, Elena Labajo-Gonzalez, and José J. Zamorano-León. 2025. "Alcohol-Related Hospitalizations Among Adolescents and Young Adults with Type 1 Diabetes in Spain, 2016−2023" Journal of Clinical Medicine 14, no. 12: 4053. https://doi.org/10.3390/jcm14124053
APA StyleJiménez-Sierra, L., López-de-Andres, A., Hernández-Barrera, V., Jiménez-Garcia, R., Carabantes-Alarcon, D., Bodas-Pinedo, A., Labajo-Gonzalez, E., & Zamorano-León, J. J. (2025). Alcohol-Related Hospitalizations Among Adolescents and Young Adults with Type 1 Diabetes in Spain, 2016−2023. Journal of Clinical Medicine, 14(12), 4053. https://doi.org/10.3390/jcm14124053