CSN-CommunityPost-Anxiety disorders increase hospital visits, costs in type 2 diabetes

Adults who have type 2 diabetes are diagnosed with an anxiety disorder visit the hospital emergency room more frequently and spend more on hospitalization than those without such diagnoses, as per findings published in Diabetes Care.

“Anxiety disorders are serious. They lead to extreme distress and harm people’s abilities to live fulfilling lives,” Esti Iturralde, Ph.D., a mental health researcher in the division of study at Kaiser Permanente Northern California in Oakland, told Endocrine Today. “Physician who treats diabetes might miss the importance of anxiety disorders due to these patients often do not look ‘sicker’ in a medical sense—but we notice that anxiety disorders contribute in problematic health care use that exposes people to unnecessary medical risks and affect the whole health care system.”

Iturralde and colleagues find for diagnoses of anxiety disorders such as obsessive-compulsive disorder, agoraphobia, and PTSD along with diagnoses of depression in health records of 143,573 adults (48.1% women, mean age 64 years) who have type 2 diabetes were participants of Kaiser Permanente Northern California of 2008 to 2012. A database provided data on ED visit frequency and hospitalization costs in 2012. The researchers defined regular visitation as three ED visits in each of the previous three years.

As per the researchers, an anxiety disorder was diagnosed in 12.9% of the study population; 52.9% with an anxiety disorder were diagnosed with depression. 35.2% go to the ED for people with an anxiety disorder at least once versus 23.6% of people without an anxiety disorder. The rate at which a people with Anxiety would visit the ED was 27% high than those without Anxiety (incidence rate ratio is 1.27; 95% CI, 1.21-1.34), as per the researchers, that the rate at which a member with depression would visit the ED was 13% higher compared to the rate for a member without depression (IRR = 1.13; 95% CI, 1.09-1.18).

Regular visitation was related in 1.5% of those with anxiety disorders than with 0.2% of those without such situation (P < .001), with the researchers noting that the risk for regular visitation was more than double for people with Anxiety (OR = 2.55; 95% CI, 1.9-3.44) and 1.66 times high for those with depression (OR = 1.66; 95% CI, 1.29-2.14). Iturralde stated that “anxiety disorder was connected with 255% higher odds of visiting the emergency room multiple times a year for many years in a row.”

Individuals with anxiety sicknesses spent an average of $5,790.45 on hospitalization in 2012, while those without such a situation spent an average of $4,105.89 (P < .001). As per the researchers, being with the top 20% of spenders in the Kaiser Permanente Northern California system was 29% more probably for people with depression (OR = 1.29; 95% CI, 1.24-1.34) or Anxiety (OR = 1.29; 95% CI, 1.23-1.36).

“Anxiety makes physiological symptoms that resemble physical signs in diabetes — so it may make people overtreat or undertreat their diabetes problem. Anxiety also lets people engage in unhelpful behaviors, like avoiding daily diabetes management duties, or becoming ‘burned out’ through unnecessary worrying or even monitoring their blood sugars too often,” Iturralde stated. “Accordingly, because the two problems are so intertwined, it makes sense for anxiety treatment to be integrated more closely with diabetes treatment.” – by Phil Neuffer.