Table 1.
Baseline characteristics by the type of treatment intensification
| Overall N = 1226 | Insulin N = 295 | OAD or GLP‐1RA N = 931 | P | |
|---|---|---|---|---|
| Mean (SD) age, years | 54.9 (10.3) | 54.1 (11.22) | 55.1 (10.01) | 0.19 |
| Age group, % | ||||
| ≥65 years | 12.9 | 13.2 | 12.8 | 0.98 |
| <65 years | 87.1 | 86.8 | 87.2 | |
| Men, % | 59.2 | 55.3 | 60.4 | 0.37 |
| Geographic region, % | 0.78 | |||
| Utah | 95.1 | 95.3 | 95.1 | |
| Idaho | 3.3 | 3.4 | 3.3 | |
| Other | 1.5 | 1.0 | 1.7 | |
| Type of health plan, % | 0.21 | |||
| Commercial | 88.8 | 86.4 | 89.6 | |
| Medicare | 8.9 | 10.2 | 8.5 | |
| Medicaid | 2.3 | 3.4 | 1.9 | |
| Mean ± SD HbA1c at baseline, mmol/mol (%) | 72.1 ± 16.6 (8.74 ± 1.51) | 81.1 ± 21.7 (9.55 ± 1.97) | 69.3 ± 15.0 (8.48 ± 1.36) | <0.01 |
| HbA1c, % | ||||
| ≥53 mmol/mol to <75 mmol/mol (≥7 to <9%) | 66.5 | 46.8 | 72.7 | <0.01 |
| ≥75 mmol/mol (≥9.0%) | 33.5 | 53.2 | 27.3 | |
| Mean ± SD HbA1c at intensification, % | 74.2 ± 18.4 (8.93 ± 1.67) | 85.6 ± 21.8 (9.96 ± 1.98) | 70.7 ± 15.7 (8.61 ± 1.43) | <0.01 |
| HbA1c, mmol/mol (%) | ||||
| ≥53 mmol/mol to <75 mmol/mol (≥7 to <9%) | 60.4 | 33.2 | 69.0 | <0.01 |
| ≥75 mmol/mol (≥9.0%) | 39.6 | 66.8 | 31.0 | |
| Mean ± SD number of HbA1c claims | ||||
| On or 1 year before intensification | 2.57 (1.11) | 2.45 (1.19) | 2.61 (1.08) | 0.05 |
| 1 year after intensification | 2.19 (1.17) | 2.27 (1.14) | 2.17 (1.18) | 0.20 |
| Mean ± SD number of HbA1c values reported by provider | ||||
| On or 1 year before intensification | 2.60 ± 1.10 | 2.53 ± 1.20 | 2.62 ± 1.07 | 0.27 |
| 1 year after intensification | 2.26 ± 1.16 | 2.35 ± 1.16 | 2.24 ± 1.16 | 0.17 |
| DCSI, % | <0.01 | |||
| DCSI 0 | 58.0 | 50.5 | 60.4 | |
| DCSI 1 | 19.3 | 18.6 | 19.5 | |
| DCSI 2 | 11.6 | 12.9 | 11.2 | |
| DCSI ≥3 | 11.1 | 18.0 | 8.9 | |
| Two OADs before intensification, % | <0.01 | |||
| MET + SU | 54.5 | 65.4 | 51.1 | |
| MET + DPP‐4 inhibitors | 28.3 | 22.7 | 30.1 | |
| MET + TZDs | 7.7 | 4.1 | 8.9 | |
| SUs + DPP‐4 inhibitors | 4.7 | 5.1 | 4.6 | |
| Other | 4.7 | 2.7 | 5.3 | |
| Mean ± SD PDC on the two OADs | 0.84 ± 0.14 | 0.84 ± 0.15 | 0.84 ± 0.14 | 0.67 |
| Conditions in DCSI calculation, % | ||||
| Ophthalmic complication (+1) | 6.0 | 9.2 | 5.0 | 0.01 |
| Ophthalmic complication (+2) | 1.5 | 1.7 | 1.5 | 1.00 |
| Nephropathy (+1) | 9.3 | 13.2 | 8.1 | 0.01 |
| Nephropathy (+2) | 4.6 | 7.1 | 3.8 | 0.02 |
| Neuropathy | 18.7 | 23.1 | 17.3 | 0.03 |
| Cerebrovascular disease (+1) | 0.3 | 0.7 | 0.2 | 0.53 |
| Cerebrovascular disease (+2) | 1.6 | 2.4 | 1.3 | 0.30 |
| Cardiovascular disease (+1) | 10.2% | 10.5% | 10.1% | 0.93 |
| Cardiovascular disease (+2) | 6.8% | 7.5% | 6.6% | 0.68 |
| Peripheral vascular disease (+1) | 1.7% | 2.0% | 1.6% | 0.82 |
| Peripheral vascular disease (+2) | 1.9% | 4.1% | 1.2% | <0.01 |
| Metabolic disease (+1) | 0.2% | 0.7% | 0.1% | 0.29 |
| Metabolic disease (+2) | 7.4% | 12.5% | 5.8% | <0.01 |
| Year of intensification (column), % | 0.86 | |||
| 2011 | 11.7 | 11.5 | 11.8 | |
| 2012 | 16.3 | 19.0 | 15.5 | |
| 2013 | 17.3 | 17.3 | 17.3 | |
| 2014 | 17.1 | 16.6 | 17.3 | |
| 2015 | 23.3 | 21.7 | 23.8 | |
| 2016 or 2017 | 14.2 | 13.9 | 14.3 | |
| Year of intensification (row), % | ||||
| 2011 | 23.6 | 76.4 | ||
| 2012 | 28.0 | 72.0 | ||
| 2013 | 24.1 | 75.9 | ||
| 2014 | 23.3 | 76.7 | ||
| 2015 | 22.4 | 77.6 | ||
| 2016 or 2017 | 23.6 | 76.4 |
Abbreviations: DCSI, Diabetes Complication Severity Index; GLP‐1RA, glucagon‐like peptide‐1 receptor agonist; MET, metformin; OAD, oral antidiabetic drug; PDC, proportion of days covered; SU, sulphonylurea; TZD, thiazolidinedione.
Note: Data for baseline characteristics were collected during the 1 year before treatment intensification if not otherwise specified.
Complication (+1), the number of patients having a record of the condition over the 1 year prior to the date of intensification that adds one point to the DSCI calculation; Complication (+2), the number of patients having a record of a severe complication that adds two points to the DSCI calculation.