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Abstract

Describing Patterns of Diabetes-Related Hospital Admissions in Northwestern Ontario: A 10-Year Retrospective Cohort Study †

by
Meagan Noble
1,
Armin Farahvash
1,2 and
Azadeh Mofid
1,2,*
1
Internal Medicine Program, Northern Ontario School of Medicine University, Thunder Bay, ON P7B 5E1, Canada
2
Department of Internal Medicine, Thunder Bay Regional Health Sciences, Thunder Bay, ON P7B 6V4, Canada
*
Author to whom correspondence should be addressed.
†
Presented at the Internal Medicine Scientific Meeting of Northern Constellations 2026, 30 April–2 May 2026, Toronto, ON, Canada.
Proceedings 2026, 143(1), 15; https://doi.org/10.3390/proceedings2026143015
Published: 10 June 2026
(This article belongs to the Proceedings of Internal Medicine Scientific Meeting of Northern Constellations 2026)
Versions Notes

Purpose: Diabetes prevalence in Northwestern Ontario (NWO) exceeds the national average, with disproportionately high rates of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS). These admissions are resource-intensive; however, local readmission rates at Thunder Bay Regional Health Sciences Centre (TBRHSC) are unknown. We aimed to describe admission patterns and factors associated with readmission.
Methods: Using ICD-10 codes, we conducted a retrospective cohort study of NWO residents admitted to TBRHSC with DKA/HHS between January 2015 and December 2024. Variables included demographics, diabetes type/duration, comorbidities, precipitating factors, length of stay (LOS), readmissions, ICU utilization, and mortality. Primary outcomes were 30-day DKA readmission and 90-day mortality; secondary outcomes included admission patterns and differences by diabetes type.
Results: Type 1 and type 2 diabetes accounted for 168 (29.9%) and 382 (68.1%) cases, respectively; 11 (2.0%) were classified as unknown. Mean diabetes duration was 13.1 ± 11.3 years, with a mean HbA1c of 11.7 ± 2.5. Common precipitants included medication non-adherence (60.6%), infection (53.8%), and alcohol/substance use (28.2%). Notably, 116 (20.7%) presented with their first hospital admission, with no prior diabetes diagnosis. Among 561 unique patients, there were 968 total hospital admissions, including 358 (36.9%) ICU stays. While 85.7% experienced a single admission, 14.3% accounted for nearly half of admissions. While 481 (85.7%) experienced a single admission, a small patient subset (80; 14.3%) accounted for nearly half of all hospitalizations. Mean LOS was 8.14 ± 15.9 days. The 30-day readmission rate was 7.0%, and 90-day mortality was 7.1%.
Conclusions: DKA/HHS represents a substantial burden in NWO, with high ICU utilization and early mortality. A small subgroup drives disproportionate hospitalizations. Ongoing analysis will further inform regionally targeted interventions to reduce recurrent metabolic decompensation and health system strain.

Author Contributions

Conceptualization, A.M. and A.F.; data curation, M.N. and A.F.; writing—original draft preparation, A.F. and M.N.; supervision, A.M. All authors have read and agreed to the published version of the manuscript.

Funding

This research was funded by NOAMA AFP Grant, number A-25-12.

Institutional Review Board Statement

Ethical review and approval were waived for this study because it is a quality improvement project.

Informed Consent Statement

Patient consent was waived because this is a retrograde chart review study.

Data Availability Statement

Data is unavailable due to privacy or ethical restrictions.

Conflicts of Interest

The authors declare no conflicts of interest.
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

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MDPI and ACS Style

Noble, M.; Farahvash, A.; Mofid, A. Describing Patterns of Diabetes-Related Hospital Admissions in Northwestern Ontario: A 10-Year Retrospective Cohort Study. Proceedings 2026, 143, 15. https://doi.org/10.3390/proceedings2026143015

AMA Style

Noble M, Farahvash A, Mofid A. Describing Patterns of Diabetes-Related Hospital Admissions in Northwestern Ontario: A 10-Year Retrospective Cohort Study. Proceedings. 2026; 143(1):15. https://doi.org/10.3390/proceedings2026143015

Chicago/Turabian Style

Noble, Meagan, Armin Farahvash, and Azadeh Mofid. 2026. "Describing Patterns of Diabetes-Related Hospital Admissions in Northwestern Ontario: A 10-Year Retrospective Cohort Study" Proceedings 143, no. 1: 15. https://doi.org/10.3390/proceedings2026143015

APA Style

Noble, M., Farahvash, A., & Mofid, A. (2026). Describing Patterns of Diabetes-Related Hospital Admissions in Northwestern Ontario: A 10-Year Retrospective Cohort Study. Proceedings, 143(1), 15. https://doi.org/10.3390/proceedings2026143015

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