Table 1.
Description of Study Population According to Insulin Initiation Category in Older Medicare Beneficiaries with Type 2 Diabetes Mellitus (T2DM): Humana Medicare Advantage Prescription Drug Database (N = 14,669)
| Characteristic | Insulin Initiation Category | P-Value | ||
|---|---|---|---|---|
| 1 OAD, n = 4,702 (32.1%) | 2 OADs, n = 6,980 (47.6%) | ≥3 OADs, n = 2,987 (20.4%) | ||
| Sex, n (%) | ||||
| Female | 2,326 (32.1) | 3,505 (48.4) | 1,417 (19.6) | .04 |
| Male | 2,376 (32.0) | 3,475 (46.8) | 1,570 (21.2) | |
| Race, n (%) | ||||
| White | 3,626 (31.9) | 5,381 (47.4) | 2,357 (20.7) | .02 |
| African American | 800 (34.1) | 1,125 (47.9) | 423 (18.0) | |
| Latino | 113 (29.5) | 189 (49.3) | 81 (21.1) | |
| Other | 163 (28.4) | 285 (49.7) | 126 (22.0) | |
| Age, n (%) | ||||
| 65–74 | 2,735 (29.7) | 4,463 (48.5) | 1,997 (21.7) | ≤.001 |
| ≥75 | 1,967 (35.9) | 2,517 (46.0) | 990 (18.1) | |
| U.S. region, n (%) | ||||
| Midwest | 1,219 (33.5) | 1,730 (47.6) | 689 (18.9) | .02 |
| South | 2,881 (31.3) | 4,420 (48.0) | 1,911 (20.7) | |
| Northeast, west, other | 602 (33.1) | 830 (45.6) | 387 (21.3) | |
| Insurance type, n (%) | ||||
| Health maintenance organization | 1,880 (30.4) | 3,084 (49.8) | 1,228 (19.8) | ≤.001 |
| Preferred provider organization | 887 (33.4) | 1,221 (46.0) | 546 (20.6) | |
| Fee for service | 1,917 (33.4) | 2,634 (45.9) | 1,192 (20.8) | |
| Other | 18 (22.5) | 41 (51.3) | 21 (26.3) | |
| Doughnut hole, n (%) | ||||
| In doughnut hole | 622 (25.2) | 1,024 (41.5) | 823 (33.3) | ≤.001 |
| Before or after doughnut hole | 4,080 (33.4) | 5,956 (48.8) | 2,164 (17.7) | |
| Any inpatient visit, n (%) | ||||
| Yes | 1,272 (40.6) | 1,398 (44.6) | 462 (14.8) | ≤.001 |
| No | 3,430 (29.7) | 5,582 (48.4) | 2,525 (21.9) | |
| Any emergency department visit, n (%) | ||||
| Yes | 1,178 (37.4) | 1,440 (45.8) | 529 (16.8) | ≤.001 |
| No | 3,524 (30.6) | 5,540 (48.1) | 2,458 (21.3) | |
| Hypoglycemia, n (%) | ||||
| Yes | 314 (38.8) | 354 (43.7) | 142 (17.5) | ≤.001 |
| No | 4,388 (31.7) | 6,626 (47.8) | 2,845 (20.5) | |
| Polypharmacy, n (%) | ||||
| >13 drugs | 804 (32.6) | 1,197 (48.5) | 469 (19.0) | .18 |
| ≤13 drugs | 3,898 (32.0) | 5,783 (47.4) | 2,518 (20.6) | |
| Urinary incontinence, n (%) | ||||
| Yes | 193 (39.7) | 206 (42.4) | 87 (17.9) | .001 |
| No | 4,509 (31.8) | 6,774 (47.8) | 2,900 (20.4) | |
| Major depressive disorder, n (%) | ||||
| Yes | 503 (38.0) | 587 (44.3) | 235 (17.7) | ≤.001 |
| No | 4,199 (31.5) | 6,393 (47.9) | 2,752 (20.6) | |
| Falls risk, n (%) | ||||
| Yes | 164 (41.0) | 177 (44.3) | 59 (14.8) | ≤.001 |
| No | 4,538 (31.8) | 6,803 (47.7) | 2,928 (20.5) | |
| Cognitive impairment, n (%) | ||||
| Yes | 895 (39.1) | 1,014 (44.3) | 381 (16.6) | ≤.001 |
| No | 3,807 (30.8) | 5,966 (48.2) | 2,606 (21.1) | |
| Dominant condition (cancer), n (%) | ||||
| Yes | 491 (32.4) | 740 (48.9) | 283 (18.7) | .23 |
| No | 4,211 (32.0) | 6,240 (47.4) | 2,704 (20.6) | |
| HbA1c, mean ± SDa | ||||
| <7.0% | 188 ± 17.5 | 256 ± 12.7 | 99 ± 10.6 | ≤.001 |
| 7.0–7.9% | 294 ± 27.3 | 574 ± 28.4 | 304 ± 32.6 | |
| 8.0–8.9% | 208 ± 19.3 | 457 ± 22.6 | 223 ± 23.9 | |
| ≥9.0% | 385 ± 35.8 | 733 ± 36.3 | 307 ± 32.9 | |
| Adapted Diabetes Complications Severity Index, n, mean ± SD | 4,702, 2.8 ± 2.2 | 6,980, 2.4 ± 2.1 | 2,987, 2.1 ± 2.0 | |
| HbA1c, n, mean ± SDa | 1,075, 8.7 ± 2.0 | 2,020, 8.6 ± 1.7 | 933, 8.6 ± 1.5 | |
SD = standard deviation.
Based on older Medicare beneficiaries with T2DM continuously enrolled in Humana Medicare Advantage Prescription Drug plans for 18 months and ≥1 oral antidiabetes drugs (OADs) during the baseline period.
Significant category differences according to insulin initiation status based on chi-square tests.
a
Based on older adults with baseline and follow-up glycosylated hemoglobin (HbA1c) data (N = 4,028).