Pearson-Stuttard J, Cheng YJ, Bennett J, et al. - In diabetics, alterations in the composition of excess risk and hospitalisation burden imply that prophylactic and clinical measures should evolve to reflect the diverse set of causes that are driving persistent excess hospitalisation in patients with diabetes.

• In this epidemiological analysis including 309,874 participants, experts analyzed trends in a broad set of cause-specific hospitalisations in patients with diabetes in England from 2003 to 2018.

• Throughout the study span, diabetics had higher hospitalisation rates for all causes, vs those without diabetes.

• In 2003, the main causes of excess (defined as absolute difference in the rate in the populations with and without diabetes) hospitalisation were: diabetes itself and ischaemic heart disease.

• By 2018, the most common causes for the same were: non-infectious and non-cancerous respiratory conditions, non-diabetes-related cancers, and ischaemic heart disease.

• Hospitalisation rates of diabetics decreased and reasons for hospitalisation changed.

• Almost all conventional diabetes complication groups declined, while an increase was evident in conditions non-specific to diabetes.

• These differing trends indicated a shift in the cause of hospitalisation; conventional diabetes complications led to more than 50% of hospitalisation in 2003, but only about 30% in 2018.

• In contrast, respiratory infections-induced hospitalisations during the same span rose from 3% to 10% in men and from 4% to 12% in women.