A longitudinal study of biomedical and psychosocial predictors of multiple hospitalizations among young people with insulin-dependent diabetes mellitus.

The aim of the present study was to estimate the cumulative probability of multiple diabetes-related hospitalizations and identify associated risk factors in a sample of 92 school-age children, newly diagnosed with insulin-dependent (Type 1) diabetes mellitus, who were followed longitudinally for up to 14 years (mean: 9 years). 'Multiple hospitalizations' as a variable was defined as three or more admissions. Altogether 26 young patients (28%) had multiple admissions (with a total of 158 hospitalizations), yielding an estimated cumulative probability for this outcome of 0.33 by 10 years after onset of diabetes. Multivariate longitudinal analyses revealed that at any given point in time, four variables significantly increased the risk of multiple admissions: higher levels of glycosylated haemoglobin reflecting poorer metabolic control, higher levels of externalizing symptoms reflecting greater behaviour problems, younger age at diagnosis, and lower socio-economic status. According to the results of post hoc analyses, however, the aforementioned risk factors do not appear to be specific to multiple hospitalizations, and can serve to identify groups that are generally vulnerable to-readmissions.