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Keywords:

  • Diabetes;
  • H1N1;
  • hospitalizations;
  • Influenza A;
  • obesity;
  • pandemic

Objectives  To describe and analyze the clinical characteristics and outcomes for all patients with diabetes who were hospitalized with laboratory-confirmed A(H1N1)pdm09 infections in Spain during 2009.

Methods  Observational retrospective study using data collected by the Spanish National Hospital Discharge Database. We selected all admissions with diagnosis ICD-9-CM code 488·1 [A(H1N1)pdm09]. Discharges were grouped as follows: no diabetes, Type1 and Type 2 diabetes. Underlying medical conditions and risk factors included all those that constitute an indication for annual influenza vaccination, pregnancy, and obesity. The outcome variables analyzed were in-hospital case fatality risk, length of hospital stay, and costs.

Results  The total number of persons hospitalized with A(H1N1)pdm09 was 11 499. Of those, 97 suffered Type 1 and 936 Type 2, giving an overall prevalence of diabetes of 9%. The most common underlying medical condition among Type 2 subjects was obesity (26·8%), and for Type 1 renal disease (10·3%). In-hospital mortality was 2·1% among Type 1 patients, 3·8% among Type 2 patients, and 2·3% among non-diabetics; after multivariate analysis, diabetes was not a factor independently associated with dying during hospitalization for A(H1N1)pdm09. Independent factors increasing the risk of death among diabetic patients included age (OR 1·03; 95% CI1·01–1·05), hematological disorders (OR 3·49; 95% CI, 1·46–8·37), and obesity (OR 1·88; 95% CI1·07–3·92).

Conclusions  Among individuals hospitalized in Spain with A(H1N1)pdm09 infections, the age-specific prevalence of diabetes was higher than the general population in most age groups. The results of multivariate analysis suggest that possibly concomitant conditions such as obesity increase the risk of dying from the infection, but not diabetes itself.