OBJECTIVE We examined national trends in diabetes-related complications (heart failure [HF], myocardial infarction [MI], stroke, end-stage renal disease [ESRD], nontraumatic lower-extremity amputation [NLEA], and hyperglycemic crisis) among U.S. adults with diagnosed diabetes during 2000–2020 by age-group, race and ethnicity, and sex. We also assessed trends in inequalities among those subgroups. RESEARCH DESIGN AND METHODS Hospitalization rates for diabetes-related complications among adults (≥18 years) were estimated using the 2000–2020 National (Nationwide) Inpatient Sample. The incidence of diabetes-related ESRD was estimated using the United States Renal Data System. The number of U.S. adults with diagnosed diabetes was estimated from the National Health Interview Survey. Annual percent change (APC) was estimated for assessment of trends. RESULTS After declines in the early 2000s, hospitalization rates increased for HF (2012–2020 APC 3.9%, P < 0.001), stroke (2009–2020 APC 2.8%, P < 0.001), and NLEA (2009–2020 APC 5.9%, P < 0.001), while ESRD incidence increased (2010–2020 APC 1.0%, P = 0.044). Hyperglycemic crisis increased from 2000 to 2020 (APC 2.2%, P < 0.001). MI hospitalizations declined during 2000–2008 (APC −6.0%, P < 0.001) and were flat thereafter. On average, age inequalities declined for hospitalizations for HF, MI, stroke, and ESRD incidence but increased for hyperglycemic crisis. Sex inequalities increased on average for hospitalizations for stroke and NLEA and for ESRD incidence. Racial and ethnic inequalities declined during 2012–2020 for ESRD incidence but increased for HF, stroke, and hyperglycemic crisis. CONCLUSIONS There was a continued increase of several complications in the past decade. Age, sex, and racial and ethnic inequalities have worsened for some complications.

中文翻译：

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2000-2020 年美国成年人糖尿病相关并发症的趋势和不平等


目的 我们研究了 2000-2020 年诊断为糖尿病的美国成年人糖尿病相关并发症 （心力衰竭 [HF] 、心肌梗死 [MI] 、中风、终末期肾病 [ESRD]、非创伤性下肢截肢 [NLEA] 和高血糖危象）的全国趋势按年龄组、种族和民族以及性别。我们还评估了这些亚组之间不平等的趋势。研究设计和方法 使用 2000-2020 年全国（全国）住院样本估计成人 （≥18 岁） 糖尿病相关并发症的住院率。使用美国肾脏数据系统估计糖尿病相关 ESRD 的发生率。被诊断患有糖尿病的美国成年人人数是根据全国健康访谈调查估计的。估计年度百分比变化 （APC） 以评估趋势。结果在 2000 年代初下降后，HF （2012-2020 APC 3.9%，P < 0.001）、中风 （2009-2020 APC 2.8%，P < 0.001） 和 NLEA （2009-2020 APC 5.9%，P < 0.001） 的住院率增加，而 ESRD 发病率增加 （2010-2020 APC 1.0%，P = 0.044）。从 2000 年到 2020 年，高血糖危象增加 （APC 2.2%，P < 0.001）。MI 住院人数在 2000-2008 年期间下降 （APC -6.0%，P < 0.001），此后持平。平均而言，HF、MI、中风和 ESRD 发生率住院的年龄不平等下降，但高血糖危象的年龄不平等增加。中风和 NLEA 住院以及 ESRD 发病率的性别不平等平均增加。2012-2020 年期间，ESRD 发病率的种族和民族不平等有所下降，但 HF、中风和高血糖危象的种族和民族不平等有所增加。结论 在过去十年中，几种并发症持续增加。 年龄、性别以及种族和民族不平等因一些并发症而恶化。