Alcohol-Related Hospitalizations Among Adolescents and Young Adults with Type 1 Diabetes in Spain, 2016-2023

Abstract

Background/Objectives: We aim to describe and analyze the clinical characteristics and hospital outcomes of alcohol-related hospital admissions (ARHAs) among adolescents and young adults (12 to 35 years) with type 1 diabetes (T1D) in Spain from 2016 to 2023. We also aim to determine factors associated with admission to the intensive care unit (ICU). Methods: A descriptive observational study was carried out based on the Spanish Hospital Discharge Database (SHDD). ICD-10 codes were used to identify ARHAs in T1D patients. Joinpoint regression was used to analyze the time trend, and multivariable logistic regression was conducted to identify predictors of ICU admission. Results: We recorded 39,091 discharges with T1D (52.59% females); of these, 1274 (3.26% prevalence) were identified as ARHAs (74.10% males vs. 25.90% females). Joinpoint regression showed a significant increase among females and stable prevalence in males. Females with T1D and ARHAs were younger than males, and more frequently had diabetic ketoacidosis (DKA), mental disorders, and external causes of morbidity and mortality, whereas greater drug use was detected among males. Overall, 20.80% of ARHAs required ICU admission. Predictors of ICU admission included DKA, drug use, hypoglycemia, and female sex (OR: 1.39; 95% CI: 1.02-1.90). Conclusions: The frequency of ARHAs in young people with T1D in Spain rose between 2016 and 2023, mainly owing to the increase in the percentage of females requiring ARHA. DKA and drug and tobacco consumption were very common in ARHAs. Admission to the ICU is frequent, increases over time, and is associated with female sex, DKA, hypoglycemia, and drug use.

Keywords: admissions; adolescents; alcohol; diabetic ketoacidosis; drug use; hospital; type 1 diabetes.

Figure 1

Joinpoint regression for the prevalence of alcohol-related hospital admission over all type 1 diabetes hospital admissions in (A) male; (B) female children and young adults in Spain (2016−2023). * Indicates that the Annual Percent Change (APC) is significantly different from zero at the alpha = 0.05 level. Final Selected Model: 0 Joinpoints.

Figure 1

Joinpoint regression for the prevalence of alcohol-related hospital admission over all type 1 diabetes hospital admissions in (A) male; (B) female children and young adults in Spain (2016−2023). * Indicates that the Annual Percent Change (APC) is significantly different from zero at the alpha = 0.05 level. Final Selected Model: 0 Joinpoints.