Diabetes-Related Hospitalizations From 2018–2023 for Children With Type 2 Diabetes

OBJECTIVE: Hospitalizations in the United States for type 2 diabetes (T2D) diagnoses in youth increased precipitously in 2020 and 2021. The subsequent trend in hospitalizations for T2D in youth is unknown. We aimed to analyze this trend from 2018 to 2023 and determine frequencies of comorbidities. METHODS: We collected semiannual counts of hospitalizations over this period for patients aged 1 to 20 years with T2D-related principal discharge billing diagnoses from 40 children's hospitals in the Pediatric Hospital Information System. We stratified data by diagnoses, sociodemographics, and quintiles of Childhood Opportunity Index 3.0. We then performed trend analyses and examined frequencies of hypertension, mental health diagnoses, and renal disease. RESULTS: In 2023, hospitalizations for T2D were 13.1% higher than in 2018 (n = 1484 vs 1679) but declined 43% from their peak in 2021 (n = 2967). The percentage of these hospitalizations due to diabetic ketoacidosis (DKA) rose from 2018 (23.2%) to 2023 (31.8%). Although individuals aged 15 years or older accounted for the highest percentage of T2D-related hospitalizations (47.1%), the percentage of T2D-related hospitalizations for youth aged under 9 years rose significantly from 2018 (5.5%) to 2023 (8.5%). In 2022 and 2023, Hispanic individuals (34.1%) accounted for the highest percentage of T2D-related hospitalizations followed by non-Hispanic Black (30.8%) and non-Hispanic white (27.3%) individuals. Comorbid mental health diagnoses (25.8%) and hypertension (10.7%) were observed throughout the study period. CONCLUSION: In 2023, T2D-related hospitalizations remained higher than pre-COVID-19 levels, and DKA accounted for a higher percentage of these hospitalizations, demonstrating increased hospital resource use for youth-onset T2D.