Table 1.
Characteristics of community-dwelling older veterans with diabetes and comorbid dementia by level of glycemic control
| Patient characteristics | All patients (n = 15,880) | Tightly controlled (n = 8,276) | Moderately controlled (n = 5,669) | Poorly controlled (n = 1,131) | Not monitored (n = 804) |
|---|---|---|---|---|---|
| Male sex | 15,643 (99) | 8,157 (99) | 5,581 (98) | 1,115 (99) | 790 (98) |
| Race/ethnicity | |||||
| Hispanic | 1,242 (8) | 566 (7) | 475 (8) | 137 (12) | 64 (8) |
| White, non-Hispanic | 12,629 (80) | 6,742 (81) | 4,489 (79) | 776 (69) | 622 (77) |
| Black, non-Hispanic | 1,618 (10) | 781 (9) | 573 (10) | 177 (16) | 87 (11) |
| Other | 391 (2) | 187 (2) | 132 (2) | 41 (4) | 31 (4) |
| Age | |||||
| 65–74 years | 3,857 (24) | 1,882 (23) | 1,442 (25) | 367 (32) | 166 (21) |
| 75–84 years | 8,745 (55) | 4,657 (56) | 3,058 (54) | 586 (52) | 444 (55) |
| ≥85 years | 3,278 (21) | 1,737 (21) | 1,169 (21) | 178 (16) | 194 (24) |
| Has medication copay | 9,515 (60) | 4,990 (60) | 3,431 (61) | 638 (56) | 456 (57) |
| Comorbidities | |||||
| Congestive heart failure | 2,860 (18) | 1,416 (17) | 1,080 (19) | 226 (20) | 138 (17) |
| Heart valve disease | 1,168 (7) | 648 (8) | 394 (7) | 69 (6) | 57 (7) |
| Peripheral vascular disease | 2,624 (17) | 1,412 (17) | 943 (17) | 166 (15) | 103 (13) |
| Hypertension | 12,815 (81) | 6,727 (81) | 4,646 (82) | 945 (84) | 497 (62) |
| Chronic lung disease | 2,979 (19) | 1,600 (19) | 1,032 (18) | 212 (19) | 135 (17) |
| Hypothyroidism | 1,628 (10) | 884 (11) | 588 (10) | 109 (10) | 47 (6) |
| Renal failure | 2,511 (16) | 1,266 (15) | 941 (17) | 211 (19) | 93 (12) |
| Solid tumor without metastasis | 2,073 (13) | 1,110 (13) | 755 (13) | 137 (12) | 71 (9) |
| Obesity | 1,080 (7) | 517 (6) | 432 (8) | 102 (9) | 29 (4) |
| Weight loss | 436 (3) | 260 (3) | 129 (2) | 20 (2) | 27 (3) |
| Fluid and electrolyte disorder | 2,016 (13) | 1,043 (13) | 722 (13) | 166 (15) | 85 (11) |
| Deficiency anemia | 3,308 (21) | 1,821 (22) | 1,168 (21) | 203 (18) | 116 (14) |
| Psychoses | 2,065 (13) | 1,105 (13) | 709 (13) | 166 (15) | 85 (11) |
| Depression | 2,463 (16) | 1,317 (16) | 858 (15) | 189 (17) | 99 (12) |
| Inpatient stay in FY2008 | 2,416 (15) | 1,246 (15) | 837 (15) | 243 (21) | 90 (11) |
| VA documentation of dementia | 11,213 (71) | 5,869 (71) | 3,958 (70) | 818 (72) | 578 (72) |
| Last HbA1c value in baseline year (FY2008)§ | |||||
| HbA1c (%) | 6.8 (6.3–7.6) | 6.3 (6.0–6.6) | 7.5 (7.2–8.0) | 9.8 (9.3–10.7) | N/A |
| HbA1c (mmol/mol) | 51 (45–60) | 45 (42–49) | 58 (55–64) | 84 (78–93) | N/A |
| Medication use in follow-up period (first 120 days of FY2009) | |||||
| Medication regimen | |||||
| Noninsulin monotherapy | 7,298 (46) | 4,942 (60) | 1,756 (31) | 156 (14) | 444 (55) |
| Noninsulin multitherapy | 3,081 (19) | 1,438 (17) | 1,337 (24) | 180 (16) | 126 (16) |
| Insulin alone | 3,308 (21) | 1,237 (15) | 1,502 (27) | 421 (37) | 148 (18) |
| Insulin plus other agent | 2,193 (14) | 659 (8) | 1,074 (19) | 374 (33) | 86 (11) |
| Medication class# | |||||
| Insulin | 5,501 (35) | 1,896 (23) | 2,576 (45) | 795 (70) | 234 (29) |
| Sulfonylurea | 8,927 (56) | 4,690 (57) | 3,204 (57) | 548 (49) | 485 (60) |
| Metformin | 6,487 (41) | 3,593 (43) | 2,238 (39) | 382 (34) | 274 (34) |
| TZDs | 826 (5.2) | 339 (4) | 375 (7) | 74 (7) | 38 (5) |
| α-Glucosidase inhibitors | 233 (1) | 81 (1) | 116 (2) | 28 (3) | 8 (1) |
| Use of medications with high hypoglycemic risk | |||||
| No insulin/no sulfonylurea | 2,842 (18) | 2,063 (25) | 598 (11) | 42 (4) | 139 (17) |
| No insulin/yes sulfonylurea | 7,537 (47) | 4,317 (52) | 2,495 (44) | 294 (26) | 431 (54) |
| Yes insulin/no sulfonylurea | 4,111 (26) | 1,523 (18) | 1,867 (33) | 541 (48) | 180 (22) |
| Yes insulin/yes sulfonylurea | 1,390 (9) | 373 (5) | 709 (13) | 254 (22) | 54 (7) |
Data are n (%) or median (interquartile range). Tightly controlled, HbA1c <7% (53 mmol/mol); moderately controlled, HbA1c 7 to <9% (53 to <75 mmol/mol); poorly controlled, HbA1c ≥9% (≥75 mmol/mol); not monitored, no evidence of having received any FY2008 HbA1c tests in VA or Medicare records. N/A, not applicable.
§Presented for the 15,076 patients with HbA1c values in FY2008.
#Data not shown for use of meglitinides, DPP-4 inhibitors, amylin analogs, and GLP-1 agonists; <1% of the total sample used these agents.