Abstract
Background: Little is known about alcohol-related harm in children and young adults with type 1 diabetes (T1D). Education on managing alcohol intake is provided to teenagers with T1D in paediatric clinics in Wales, but its effectiveness is unknown. We compared the patterns in risk of alcohol-related hospital admissions (ARHA) between individuals with and without childhood-onset T1D. Methods: We extracted data for 1 791 577 individuals born during 1979 to 2014 with a general practitioner registration in Wales, and record-linked the demographic data to ARHA between 1998 and June 2016 within the Secure Anonymised Information Linkage Databank (SAIL). Linkage to a national T1D register (Brecon Cohort) identified 3575 children diagnosed aged <15 years since 1995. We estimated hazard ratios (HRs) with 95% confidence intervals (95% CIs) for the risk of ARHA using recurrent-event models, including interaction terms. Results: Individuals with T1D had a higher riskof ARHA (HR: 1.78; 95% CI: 1.60-1.98), adjusted for age group, sex, and deprivation. The risk in people with diabetes was highest aged 14 to 17 years, around three times higher than the peak in non-T1D aged 18 to 22. Females with diabetes had a lower risk generally. The association between deprivation and ARHA was weaker in the T1D group. Conclusion: Young people with T1D had increased risks of ARHA, particularly at school age, and smaller socioeconomic inequalities in ARHA. A review of interventions to reduce alcohol-related harm in T1D is needed, perhaps including modification of current education and guidance for teenagers on managing alcohol consumption and reviewing criteria for hospital admission.
| Original language | English |
|---|---|
| Pages (from-to) | 1333-1342 |
| Number of pages | 10 |
| Journal | Pediatric Diabetes |
| Volume | 21 |
| Issue number | 7 |
| Early online date | 19 Aug 2020 |
| DOIs | |
| Publication status | Published - 30 Nov 2020 |
Bibliographical note
AcknowledgementsAG was funded by the National Centre for Population Health and Wellbeing Research Wales (WCPHWR), and SP, DF, and JG are members of the NCPHWR team in Cardiff University. We would like to thank the Brecon Group (which comprises all paediatricians and paediatric diabetes healthcare staff in Wales with an interest in Diabetes and endocrinology). The Brecon Group was supported initially by grants from NovoNordisk and subsequently the Welsh Government. Funds from the Economic and Social Research Council, the Medical Research Council, and Alcohol Research UK supported the establishment of the ELASTiC data platform.This study used anonymised data held in the Secure Anonymised Information Linkage (SAIL) Databank. We would like to acknowledge all the data providers who enable SAIL to make anonymised data available for research.
Data sharing
The datasets used in this study are available in the SAIL Databank at Swansea University, Swansea, UK, but as restrictions apply, they are not publicly available. All proposals to use SAIL data are subject to review by an independent Information Governance Review Panel (IGRP). Before any data can be accessed, approval must be given by the IGRP. The IGRP gives careful consideration to each project to ensure proper and appropriate use of SAIL data. When access has been granted, it is gained through a privacy-protecting safe haven and remote access system referred to as the SAIL Gateway. SAIL has established an application process to be followed by anyone who would like to access data via SAIL at
https://www.saildatabank.com/application-process.
Funding information: Alcohol Research UK; Medical Research Council; Economic and Social Research Council; Welsh Government; Novo Nordisk; Brecon Group; National Centre for Population Health and Wellbeing Research Wales
Keywords
- Alcohol Drinking
- Diabetes Mellitus
- Type I
- Socioeconomic Factors
- Child
- Young Adult
- type 1
- socioeconomic factors
- young adult
- diabetes mellitus
- alcohol drinking
- child
- MANAGEMENT
- EVENTS
- KETOACIDOSIS
- MELLITUS
- ALL-CAUSE MORTALITY
- ADOLESCENTS
- HYPOGLYCEMIA
- CONSUMPTION
Access to Document
- Gartner_et_al_PedDiab_DemographicAndSocioeconomic_AAM
This is the peer reviewed version of the following article: Gartner, A, Daniel, R, Farewell, D, Paranjothy, S, Townson, J, Gregory, JW. Demographic and socioeconomic patterns in the risk of alcohol‐related hospital admission in children and young adults with childhood onset type‐1 diabetes from a record‐linked longitudinal population cohort study in Wales. Pediatr Diabetes. 2020; 1– 10. , which has been published in final form at https://doi.org/10.1111/pedi.13089 . This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
- Gartner_et_al_PD_DemographicAndSocioeconomicPatterns_VoR
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2020 The Authors. Pediatric Diabetes published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc/4.0/