Nip ASY, Lodish M, et al. - In people with type 1 diabetes (T1D), hospital admission increased significantly during the transition period from adolescence to adulthood in the state of California. The results indicate that the health care system fails many emerging adults with diabetes, especially for persons of color, and that enhancing medical transition is important.

• In this retrospective study utilizing the statewide inpatient database (California) for years 2014–2018, a total of 34,749 admission encounters (in individuals aged 13–24 years) for T1D and 3,304 for type 2 diabetes were analyzed.

• A significant increase in hospitalization rates was evident with age during the transition to adulthood, from 70/100,000 California population at age 17 to 132/100,000 at age 19 in T1D.

• Young adults (ages 19–24) had higher hospitalization rates than youth (ages 13–18) in T1D, and a significantly higher rate was seen in Black young adults (23.9%) vs youth (12.0%) among the age-adjusted population with diabetes.

• Having public insurance and lower socioeconomic status was identified in significantly more Black young adults.

• Young adults encountered higher hospital charges and were three times more likely to be admitted for severe conditions.