TABLE 1.
Baseline Demographic and Clinical Characteristics
| Characteristic/Category | MarketScan (n = 181,423) | Optum EMR Database (n = 84,759) | Optum Integrated Database (n = 8,948) |
|---|---|---|---|
| Age, in years, n (%) | |||
| 0 to < 6 | 2,878 (1.6) | 1,270 (1.5) | 102 (1.1) |
| 6 to < 13 | 16,585 (9.1) | 6,418 (7.6) | 508 (5.7) |
| 13 to < 18 | 19,369 (10.7) | 7,566 (8.9) | 742 (8.3) |
| 18 to < 26 | 29,245 (16.1) | 13,242 (15.6) | 1,355 (15.1) |
| 26 to < 50 | 75,977 (41.9) | 34,508 (40.7) | 4,208 (47.0) |
| 50 to < 65 | 31,671 (17.5) | 15,235 (18.0) | 1,614 (18.0) |
| ≥ 65 | 5,698 (3.1) | 6,520 (7.7) | 419 (4.7) |
| Gender, n (%) | |||
| Male | 96,275 (53.1) | 44,703 (52.7) | 4,710 (52.6) |
| Female | 85,148 (46.9) | 39,979 (47.2) | 4,233 (47.3) |
| Unknown | 0 (0.0) | 77 (0.1) | 5 (0.1) |
| Index date, year, n (%) | |||
| 2011 | 90,663 (50.0) | 19,385 (22.9) | 3,237 (36.2) |
| 2012 | 32,091 (17.7) | 16,581 (19.6) | 1,294 (14.5) |
| 2013 | 23,023 (12.7) | 13,126 (15.5) | 1,136 (12.7) |
| 2014 | 21,820 (12.0) | 13,228 (15.6) | 1,067 (11.9) |
| 2015 | 13,826 (7.6) | 12,066 (14.2) | 1,015 (11.3) |
| 2016 | 0 (0.0) | 10,373 (12.2) | 1,199 (13.4) |
| Race, n (%) | |||
| White | N/A | 70,067 (82.7) | 7,517 (84.0) |
| African American | N/A | 6,540 (7.7) | 368 (4.1) |
| Asian | N/A | 626 (0.7) | 53 (0.6) |
| Other/unknown | N/A | 7,526 (8.9) | 1,010 (11.3) |
| Ethnicity, n (%) | |||
| Hispanic | N/A | 3,528 (4.2) | 334 (3.7) |
| Non-Hispanic | N/A | 72,346 (85.4) | 7,103 (79.4) |
| Unknown | N/A | 8,885 (10.5) | 1,511 (16.9) |
| Geographic region, n (%) | |||
| Northeast | 31,854 (17.6) | 8,653 (10.2) | 915 (10.2) |
| North Central/Midwest | 44,838 (24.7) | 38,233 (45.1) | 3,291 (36.8) |
| South | 67,235 (37.1) | 27,132 (32.0) | 3,483 (38.9) |
| West | 33,011 (18.2) | 7,184 (8.5) | 888 (9.9) |
| Unknown | 4,485 (2.5) | 3,557 (4.2) | 371 (4.1) |
| Provider type at index, n (%) | |||
| Endocrinologist | 35,495 (19.6) | 26,735 (31.5) | 2,623 (29.3) |
| Primary care physician | 47,533 (26.2) | 18,333 (21.6) | 2,056 (23.0) |
| Provider type at index, n (%) | |||
| Urgent care/emergency medicine/inpatient | 16,604 (9.2) | 13,142 (15.5) | 294 (3.3) |
| Other | 81,791 (45.1) | 26,549 (31.3) | 3,975 (44.4) |
| Baseline continuous enrollment, in months | |||
| Mean (SD) | 8.2 (2.0) | 10.6 (2.1) | 8.2 (2.0) |
| Median (IQR) | 7.5 (6.0-12.0) | 12.0 (6.0-12.0) | 7.5 (6.0-12.0) |
| Available baseline HbA1c measure, n (%) | 6,703 (3.7) | 54,906 (64.8) | 1,340 (15.0) |
| Baseline HbA1c, n (%)a | |||
| < 6.0% | 217 (3.2) | 1,801 (3.3) | 40 (3.0) |
| 6.0 to < 7.0% | 1,160 (17.3) | 8,000 (14.6) | 218 (16.3) |
| 7.0 to < 8.0% | 2,011 (30.0) | 14,165 (25.8) | 397 (29.6) |
| 8.0 to < 9.0% | 1,432 (21.4) | 12,130 (22.1) | 319 (23.8) |
| 9.0 to < 10.0% | 828 (12.4) | 7,437 (13.5) | 183 (13.7) |
| 10.0 to < 11.0% | 433 (6.5) | 4,286 (7.8) | 80 (6.0) |
| 11.0 to < 12.0% | 277 (4.1) | 2,652 (4.8) | 48 (3.6) |
| 12.0 to < 13.0% | 144 (2.1) | 1,765 (3.2) | 25 (1.9) |
| 13.0 to < 14.0% | 107 (1.6) | 1,117 (2.0) | 10 (0.7) |
| ≥ 14.0 | 94 (1.4) | 1,553 (2.8) | 20 (1.5) |
| CCI score, n (%) | |||
| 1 | 132,483 (73.0) | 60,995 (72.0) | 6,188 (69.2) |
| 2 | 34,995 (19.3) | 13,962 (16.5) | 1,889 (21.1) |
| 3+ | 13,945 (7.7) | 9,802 (11.6) | 871 (9.7) |
| Selected comorbidities, n (%) | |||
| Any autoimmune thyroid disease | 26,530 (14.6) | 13,448 (15.9) | 1,707 (19.1) |
| Hyperthyroidism | 1,650 (0.9) | 856 (1.0) | 119 (1.3) |
| Hypothyroidism | 23,024 (12.7) | 11,888 (14.0) | 1,505 (16.8) |
| Hashimoto’s thyroiditis | 3,831 (2.1) | 1,636 (1.9) | 217 (2.4) |
| Hypertension | 35,083 (19.3) | 21,807 (25.7) | 2,294 (25.6) |
| Hyperlipidemia | 47,728 (26.3) | 24,095 (28.4) | 3,125 (34.9) |
| Depression | 11,936 (6.6) | 7,423 (8.8) | 755 (8.4) |
| Anxiety | 10,296 (5.7) | 5,653 (6.7) | 723 (8.1) |
| Celiac disease | 1,988 (1.1) | 1,004 (1.2) | 104 (1.2) |
| Asthma | 6,333 (3.5) | 3,730 (4.4) | 303 (3.4) |
| Limited joint mobility | 2,830 (1.6) | 997 (1.2) | 180 (2.0) |
| Osteoporosis/osteopenia | 3,794 (2.1) | 2,249 (2.7) | 253 (2.8) |
| Diabetic complications, n (%) | |||
| Diabetic ketoacidosis | 13,401 (7.4) | 6,192 (7.3) | 593 (6.6) |
| Hyperglycemia | 109,056 (60.1) | 38,015 (44.9) | 4,699 (52.5) |
| Hypoglycemia | 20,561 (11.3) | 7,665 (9.0) | 1,024 (11.4) |
| Any microvascular complications | 39,667 (21.9) | 14,971 (17.7) | 2,830 (31.6) |
| Diabetic neuropathy | 14,064 (7.8) | 7,234 (8.5) | 1,478 (16.5) |
| Diabetic retinopathy | 26,624 (14.7) | 8,065 (9.5) | 1,584 (17.7) |
| Diabetic nephropathy | 8,438 (4.7) | 4,130 (4.9) | 1,140 (12.7) |
| Any macrovascular complications | 12,983 (7.2) | 9,336 (11.0) | 710 (7.9) |
| Coronary heart disease | 10,429 (5.7) | 7,765 (9.2) | 586 (6.5) |
| Congestive heart failure | 1,717 (0.9) | 1,900 (2.2) | 112 (1.3) |
| Cerebrovascular disease | 2,306 (1.3) | 1,705 (2.0) | 129 (1.4) |
| Peripheral vascular disease | 2,454 (1.4) | 1,939 (2.3) | 139 (1.6) |
| Baseline insulin useb | |||
| Any insulin | 160,790 (88.6) | 63,891 (75.4) | 7,856 (87.8) |
| Rapid-acting insulin | 147,437 (81.3) | 54,068 (63.8) | 7,294 (81.5) |
| Short/intermediate-acting insulin | 8,582 (4.7) | 10,797 (12.7) | 390 (4.4) |
| Long-acting insulin | 74,346 (41.0) | 35,494 (41.9) | 3,842 (42.9) |
| Insulin combination | 4,631 (2.6) | 2,477 (2.9) | 161 (1.8) |
| Insulin administration procedurec | 3,518 (1.9) | 5,628 (6.6) | 48 (0.5) |
| Other diabetic supplies and management | |||
| Insulin pump and accessories | 79,681 (43.9) | 2,682 (3.2) | 3,824 (42.7) |
| Glucose test strips | 100,659 (55.5) | 27,350 (32.3) | 5,848 (65.4) |
| Glucose monitoring system | 23,211 (12.8) | 3,666 (4.3) | 1,400 (15.6) |
| Diabetes self-care managementd | 67,684 (37.3) | 23,596 (27.8) | 3,587 (40.1) |
a Proportion of HbA1c categories were calculated using the number of patients with available HbA1c data as the denominator.
b All patients in the study received insulin, since those patients who did not have a claim for insulin during the baseline period had 1 within 90 days of the index date.
c Insulin administration procedures are an administration of insulin during a medical visit.
d Diabetes self-care management represents a set of procedure codes that providers can use to bill for teaching patients how to check their blood glucose, take insulin, or perform similar activities. We suspected that these codes may be a way to identify patients who were newly diagnosed with type 1 diabetes.
CCI = Charlson Comorbidity Index; EMR = electronic medical record; HbA1c = glycated hemoglobin; IQR = interquartile range; N/A = not applicable; SD = standard deviation.