Table 1.
Patient baseline and clinical characteristics
| Normoalbuminuria | Microalbuminuria | Macroalbuminuria | [A] vs. [B] | [A] vs. [C] | [B] vs. [C] | |
|---|---|---|---|---|---|---|
| [A] | [B] | [C] | ||||
| N = 18,409 | N = 3863 | N = 963 | ||||
| Age at index date (years), mean ± SD | 54.3 ± 9.6 | 54.9 ± 10.2 | 56.0 ± 10.3 | § | ‡ | |
| Male, n (%) | 9836 (53%) | 2310 (60%) | 602 (63%) | * | § | |
| Region, n (%) | ||||||
| Northeast | 3577 (19%) | 686 (18%) | 180 (19%) | * | ||
| North-Central | 4687 (25%) | 1029 (27%) | 289 (30%) | § | ‡ | |
| South | 7666 (42%) | 1687 (44%) | 378 (39%) | * | ‡ | |
| West | 2475 (13%) | 461 (12%) | 116 (12%) | * | ||
| Insurance plan type, n (%) | ||||||
| Preferred provider organization | 13,833 (75%) | 2856 (74%) | 711 (74%) | |||
| Non-capitated point-of-service | 1421 (8%) | 250 (6%) | 39 (4%) | * | § | ‡ |
| Exclusive provider organization | 911 (5%) | 191 (5%) | 52 (5%) | |||
| Comprehensive traditional plan | 1597 (9%) | 434 (11%) | 136 (14%) | * | § | ‡ |
| Other plans | 647 (4%) | 132 (3%) | 25 (3%) | |||
| Time from first observed type 2 diabetes diagnosis in the database to the index date (months), mean ± SD | 37.8 ± 26.6 | 40.5 ± 27.9 | 44.0 ± 30.5 | * | § | ‡ |
| Index urine albumin test characteristics | ||||||
| 24-h urine albumin (mg) | ||||||
| n (%) | 208 (1%) | 57 (1%) | 24 (2%) | |||
| Mean ± SD | 7.5 ± 7.1 | 97.9 ± 73.5 | 2289.4 ± 2044.7 | * | § | ‡ |
| Median [min, max] | 7.2 [0.0, 29.1] | 73.0 [30.0, 281.0] | 1519.5 [315.0, 7140.2] | |||
| Albumin/creatinine ratio (µg/mg) | ||||||
| n (%) | 18,201 (99%) | 3806 (99%) | 939 (98%) | |||
| Mean ± SD | 7.6 ± 6.5 | 88.6 ± 62.7 | 3439.6 ± 11,630.7 | * | § | ‡ |
| Median [min, max] | 6.0 [0.0, 29.8] | 64.5 [30.0, 297.0] | 734.0 [300.4, 90,000.0] | |||
| CCI, mean ± SD | 1.6 ± 1.1 | 1.9 ± 1.4 | 2.5 ± 1.7 | * | § | ‡ |
| Disease-specific comorbidities, n (%) | ||||||
| Neuropathy | 2355 (13%) | 618 (16%) | 218 (23%) | * | § | ‡ |
| Ischemic heart disease | 2191 (12%) | 602 (16%) | 192 (20%) | * | § | ‡ |
| Retinopathy | 2004 (11%) | 593 (15%) | 251 (26%) | * | § | ‡ |
| Anemia | 1358 (7%) | 356 (9%) | 155 (16%) | * | § | ‡ |
| Depression | 1198 (7%) | 219 (6%) | 51 (5%) | |||
| Cerebrovascular disease | 852 (5%) | 255 (7%) | 102 (11%) | * | § | ‡ |
| Heart failure | 370 (2%) | 159 (4%) | 60 (6%) | * | § | ‡ |
| Ketoacidosis | 150 (1%) | 37 (1%) | 22 (2%) | § | ‡ | |
| Hyperkalemia | 111 (1%) | 55 (1%) | 23 (2%) | * | § | ‡ |
| High parathyroid hormone level | 106 (1%) | 33 (1%) | 22 (2%) | * | § | ‡ |
| High phosphorus level | 16 (<1%) | 5 (<1%) | 3 (<1%) | |||
| Disease-specific treatments, n (%) | ||||||
| Nephropathy-related treatments | 12,726 (69%) | 3032 (78%) | 830 (86%) | * | § | ‡ |
| ACE inhibitor | 6199 (34%) | 1548 (40%) | 427 (44%) | * | § | ‡ |
| Diuretic | 3276 (18%) | 850 (22%) | 339 (35%) | * | § | ‡ |
| Calcium channel blocker | 2330 (13%) | 811 (21%) | 296 (31%) | * | § | ‡ |
| ARB | 2293 (12%) | 654 (17%) | 208 (22%) | * | § | ‡ |
| Other antihypertensive agents | 4661 (25%) | 1132 (29%) | 369 (38%) | * | § | ‡ |
| Diabetic treatments, n (%) | 15,177 (82%) | 3363 (87%) | 852 (88%) | * | § | |
| Metformin | 11,548 (63%) | 2532 (66%) | 510 (53%) | * | § | ‡ |
| Sulfonylureas | 4293 (23%) | 1125 (29%) | 314 (33%) | * | § | ‡ |
| Insulin | 3915 (21%) | 1179 (31%) | 459 (48%) | * | § | ‡ |
| DPP4 inhibitor | 1756 (10%) | 438 (11%) | 111 (12%) | * | § | |
| GLP1-based therapy | 1279 (7%) | 293 (8%) | 72 (7%) | |||
| SGLT2 inhibitor | 3 (<1%) | 0 (0%) | 0 (0%) | |||
| Other antidiabetic agents | 3847 (21%) | 911 (24%) | 259 (27%) | * | § | ‡ |
| All-cause healthcare resource utilization | ||||||
| Patients with ≥1 visit, n (%) | ||||||
| Inpatient admissions | 1490 (8%) | 453 (12%) | 169 (18%) | * | § | ‡ |
| ER services | 4150 (23%) | 984 (25%) | 263 (27%) | * | § | |
| Outpatient services | 18,226 (99%) | 3817 (99%) | 952 (99%) | |||
| Other | 10,073 (55%) | 2186 (57%) | 610 (63%) | * | § | ‡ |
| Number of visits per patient, mean ± SD | ||||||
| Inpatient admissions | 0.1 ± 0.4 | 0.2 ± 0.5 | 0.2 ± 0.6 | * | § | ‡ |
| Inpatient days | 0.5 ± 2.9 | 0.8 ± 3.4 | 1.4 ± 4.5 | * | § | ‡ |
| ER services | 0.4 ± 1.2 | 0.5 ± 1.4 | 0.6 ± 2.0 | * | § | |
| Outpatient services | 12.9 ± 12.6 | 12.9 ± 12.4 | 14.0 ± 12.4 | § | ‡ | |
| Other | 2.0 ± 4.1 | 2.5 ± 4.9 | 3.5 ± 6.7 | * | § | ‡ |
| All-cause healthcare costs (2016 USD), mean ± SD | ||||||
| Total healthcare costs | 10,602.7 ± 19,847.4 | 12,882.6 ± 25,539.6 | 15,849.0 ± 23,728.3 | * | § | ‡ |
| Total medical costs | 7108.4 ± 18,682.0 | 9018.6 ± 24,305.0 | 11,184.5 ± 21,995.8 | * | § | ‡ |
| Total pharmaceutical costs | 3494.3 ± 4869.1 | 3864.0 ± 5130.1 | 4664.5 ± 6426.0 | * | § | ‡ |
ACE angiotensin-converting enzyme, ARB angiotensin II receptor blocker, CCI Charlson comorbidity index, DPP4 dipeptidyl peptidase 4, ER emergency room, GLP 1 glucagon-like peptide-1, N number, SD standard deviation, SGLT2 sodium-glucose cotransporter 2, USD United States dollars
* p < 0.05 for [A] vs. [B]; § p < 0.05 for [A] vs. [C]; ‡ p < 0.05 for [B] vs. [C]