Table 1.
Patient baseline characteristics, demographics, comorbidities, complications, medications and resource use
| Characteristics | Patient groupa | P valuesb | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| All patients | Dual-goal | LDL-C goal | HbA1c goal | No goal | LDL-C vs. dual | HbA1c vs. dual | None vs. dual | LDL-C vs. none | HbA1c vs. none | |
| Unique patients, n (%) | 16,829 | 6558 (39.0) | 2432 (14.5) | 5414 (32.2) | 2425 (14.40) | |||||
| Demographics | ||||||||||
| Age as of the index date, yearsc | 63.3 | 66.2 | 61.8 | 62.5 | 58.7 | <.001 | <.001 | <.001 | <.001 | <.001 |
| Age groups, n (%) | ||||||||||
| 18–44 | 666 (4.0) | 125 (1.9) | 113 (4.7) | 237 (4.4) | 191 (7.9) | |||||
| 45–54 | 2579 (15.3) | 630 (9.6) | 442 (18.2) | 884 (16.3) | 623 (25.7) | |||||
| 55–64 | 6996 (41.6) | 2473 (37.7) | 1098 (45.2) | 2342 (43.3) | 1083 (44.7) | |||||
| 65–69 | 1995 (11.9) | 929 (14.2) | 261 (10.7) | 605 (11.2) | 200 (8.3) | |||||
| 70–74 | 1887 (11.2) | 945 (14.4) | 216 (8.9) | 578 (10.7) | 148 (6.1) | |||||
| 75–79 | 1534 (9.1) | 830 (12.7) | 160 (6.6) | 439 (8.1) | 105 (4.3) | |||||
| 80+ | 1172 (7.0) | 626 (9.6) | 142 (5.8) | 329 (6.1) | 75 (3.1) | |||||
| Male, n (%) | 16,293 (96.8) | 6419 (97.9) | 2373 (97.6) | 5180 (95.7) | 2321 (95.7) | .379 | <.001 | <.001 | <.001 | .946 |
| White, n (%) | 11,269 (67.0) | 4626 (70.5) | 1623 (66.7) | 3562 (65.8) | 1458 (60.1) | <.001 | <.001 | <.001 | <.001 | <.001 |
| Body mass index, kg/m2c | 31.8 | 31.5 | 32.3 | 31.7 | 32.5 | <.001 | .0657 | <.001 | .069 | <.001 |
| Index year, n (%)2 | <.001 | <.001 | <.001 | <.001 | <.001 | |||||
| 2004 | 2816 (16.7) | 1134 (17.3) | 381 (15.7) | 934 (17.3) | 367 (15.1) | |||||
| 2005 | 3884 (23.1) | 1498 (22.8) | 460 (18.9) | 1407 (26.0) | 519 (21.4) | |||||
| 2006 | 2899 (17.2) | 1029 (15.7) | 387 (15.9) | 1002 (18.5) | 481 (19.8) | |||||
| 2007 | 2832 (16.8) | 1123 (17.1) | 423 (17.4) | 858 (15.9) | 428 (17.7) | |||||
| 2008 | 2864 (17.0) | 1176 (17.9) | 505 (20.8) | 789 (14.6) | 394 (16.3) | |||||
| 2009 | 1534 (9.1) | 598 (9.1) | 276 (11.4) | 424 (7.8) | 236 (9.7) | |||||
| Diabetes-related complications, n (%) | ||||||||||
| Microvascular complications | 3217 (19.1) | 1186 (18.1) | 561 (23.1) | 935 (17.3) | 535 (22.1) | <.001 | .245 | <.001 | .402 | <.001 |
| Macrovascular complications | 6455 (38.4) | 3058 (46.6) | 1044 (42.9) | 1677 (31.0) | 676 (27.9) | .002 | <.001 | <.001 | <.001 | .006 |
| Other complications | ||||||||||
| Infectiond | 2185 (13.0) | 918 (14.0) | 273 (11.2) | 721 (13.3) | 273 (11.3) | .001 | .281 | .001 | .971 | .011 |
| Ocular problemse | 5069 (30.1) | 2073 (31.6) | 708 (29.1) | 1640 (30.3) | 648 (26.7) | .023 | .121 | <.001 | .063 | .001 |
| Ulceration | 321 (1.9) | 140 (2.1) | 59 (2.4) | 75 (1.4) | 47 (1.9) | .404 | .002 | .562 | .245 | .068 |
| Ketoacidosis and hyperosmolarity | 59 (0.4) | 5 (0.1) | 25 (1.0) | 4 (0.1) | 25 (1.0) | <.001 | .963 | <.001 | .992 | <.001 |
| Diabetic coma | 30 (0.2) | 3 (0.1) | 8 (0.3) | 5 (0.1) | 14 (0.6) | .001 | .326 | <.001 | .197 | <.001 |
| Hypoglycemia | 492 (2.9) | 167 (2.6) | 112 (4.6) | 127 (2.4) | 86 (3.6) | <.001 | .480 | .011 | .062 | .003 |
| Comorbidities, n (%) | ||||||||||
| Congestive heart failure | 1031 (6.1) | 473 (7.2) | 195 (8.0) | 227 (4.2) | 136 (5.6) | .196 | <.001 | .007 | .001 | .006 |
| Valvular heart disease | 305 (1.8) | 152 (2.3) | 38 (1.6) | 85 (1.6) | 30 (1.2) | .027 | .003 | .001 | .335 | .257 |
| Hypertension | 13,346 (79.3) | 5411 (82.5) | 1922 (79.0) | 4173 (77.1) | 1840 (75.9) | <.001 | <.001 | <.001 | .009 | .245 |
| Hyperlipidemia | 12,261 (72.9) | 4781 (72.9) | 1655 (68.1) | 4106 (75.8) | 1719 (70.9) | <.001 | <.001 | .058 | .032 | <.001 |
| Depression | 6641 (39.5) | 2276 (34.7) | 958 (39.4) | 2352 (43.4) | 1055 (43.5) | <.001 | <.001 | <.001 | .004 | .959 |
| Tobacco use | 3312 (19.7) | 1101 (16.8) | 516 (21.3) | 1153 (21.3) | 539 (22.2) | <.001 | <.001 | <.001 | .454 | .355 |
| Renal disease | 1439 (8.6) | 646 (9.90) | 248 (10.2) | 370 (6.8) | 175 (7.2) | .625 | <.001 | <.001 | <.001 | .538 |
| Surgical procedures, n (%) | ||||||||||
| Lower extremity amputation | 41 (0.2) | 14 (0.2) | 13 (0.5) | 9 (0.2) | 5 (0.2) | .013 | .557 | .947 | .060 | .699 |
| Coronary artery bypass graft | 89 (0.5) | 39 (0.6) | 12 (0.5) | 23 (0.4) | 15 (0.6) | .570 | .197 | .897 | .558 | .254 |
| Percutaneous coronary intervention | 234 (1.4) | 106 (1.6) | 45 (1.9) | 51 (0.9) | 32 (1.3) | .443 | .001 | .310 | .139 | .131 |
| Diabetic medications, n (%) | ||||||||||
| Oral antidiabetic | 8888 (52.8) | 2837 (43.3) | 1866 (76.7) | 2301 (42.5) | 1884 (77.7) | <.001 | .404 | <.001 | .423 | <.001 |
| Insulin | 1709 (10.2) | 330 (5.0) | 634 (26.1) | 239 (4.4) | 506 (20.9) | <.001 | .114 | <.001 | <.001 | <.001 |
| Antihypertensives | 11,432 (67.9) | 4504 (68.7) | 1802 (74.1) | 3479 (64.3) | 1647 (67.9) | <.001 | <.001 | .490 | <.001 | .002 |
| Lipid lowering | 11,676 (69.4) | 4610 (70.3) | 1745 (71.8) | 3651 (67.4) | 1670 (68.9) | .178 | .001 | .190 | .028 | .210 |
| Resource utilization, n (%) | ||||||||||
| Inpatient visit | 1693 (10.1) | 576 (8.8) | 359 (14.8) | 449 (8.3) | 309 (12.7) | <.001 | .340 | <.001 | .041 | <.001 |
| Emergency room visit | 636 (3.8) | 230 (3.5) | 122 (5.0) | 172 (3.2) | 112 (4.6) | .001 | .318 | .015 | .517 | .002 |
| Outpatient visit | 16,592 (98.6) | 6471 (98.7) | 2392 (98.4) | 5334 (98.5) | 2395 (98.8) | .256 | .483 | .740 | .233 | .403 |
All characteristics were measured in the first 6-month cycle
HbA1c glycosylated hemoglobin A1c, LDL-C low-density lipoprotein cholesterol
aDual-goal achievement was defined as HbA1c <7% (53 mmol/mol) and LDL-C <100 mg/dL; LDL-C goal achievement, LDL-C <100 mg/dL and HbA1c ≥7% (53 mmol/mol); HbA1c goal achievement, HbA1c <7% (53 mmol/mol) and LDL-C ≥100 mg/dL; no goal achievement, HbA1c ≥7% (53 mmol/mol) and LDL-C ≥100 mg/dL
b P values for categorical variables were obtained using Chi-square tests; P values for continuous variables were obtained using ANOVA tests. Statistical significance is indicated with bolded text
cIncludes infection, ocular problems, ulceration (foot ulcer, bone changes, amputation, and other ulceration), ketoacidosis without coma and hyperosmolarity, diabetic coma, and hypoglycemia
dIncludes skin, urinary tract, and kidney
eIncludes glaucoma, macular edema, retinal edema, vitreous hemorrhage, and blindness