Table 1.
Distribution of Patient Covariates of Patients who Initiated Pioglitazone, Dipeptidyl-peptidase-4, or Sulfonylureas
| PIO* (N=38,700) | DPP (N=82,552) | SMRW DPP† | PIO* (N=20,075) | SU (N=126,104) | SMRW SU† | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Variable | N | % | N | % | % | N | % | N | % | % | |||
| DEMOGRAPHIC CHARACTERISTICS AT DRUG INITIATION | |||||||||||||
| Age, Mean, Median (IQR) | 74.9, 74 (69,79) | 75.8, 75 (70,81) | 74.8, 73 (69,79) | 75.9, 75 (70,81) | |||||||||
| Age 66 to <70 | 10,050 | 26.0 | 18,838 | 22.8 | 26.1 | 5,316 | 26.5 | 29,020 | 23.0 | 26.4 | |||
| Age 70 to <75 | 11,195 | 28.9 | 22,311 | 27.0 | 29.0 | 5,832 | 29.1 | 33,267 | 26.4 | 29.1 | |||
| Age 75 to <80 | 8,018 | 20.7 | 17,356 | 21.0 | 20.6 | 4,144 | 20.6 | 25,689 | 20.4 | 20.7 | |||
| Age 80 to <85 | 5,495 | 14.2 | 12,925 | 15.7 | 14.2 | 2,733 | 13.6 | 19,616 | 15.6 | 13.6 | |||
| Age >=85 | 3,942 | 10.2 | 11,122 | 13.5 | 10.0 | 2,050 | 10.2 | 18,512 | 14.7 | 10.2 | |||
| Male | 16,280 | 42.1 | 31,683 | 38.4 | 42.3 | 8,350 | 41.6 | 51,459 | 40.8 | 41.7 | |||
| White | 27,849 | 72.0 | 62,274 | 75.4 | 72.6 | 14,332 | 71.4 | 98,793 | 78.3 | 71.3 | |||
| Black | 4,676 | 12.1 | 9,165 | 11.1 | 11.7 | 2,411 | 12.0 | 14,999 | 11.9 | 12.0 | |||
| Other Race‡ | 6,175 | 16.0 | 11,113 | 13.5 | 15.7 | 3,332 | 16.6 | 12,312 | 9.8 | 16.7 | |||
| Drug Initiation Year: 2007 | 2,384 | 6.2 | 1,915 | 2.3 | 6.1 | 1,138 | 5.7 | 4,278 | 3.4 | 5.7 | |||
| Drug Initiation Year: 2008 | 9,515 | 24.6 | 7,459 | 9.0 | 24.5 | 4,511 | 22.5 | 17,222 | 13.7 | 22.5 | |||
| Drug Initiation Year: 2009 | 8,362 | 21.6 | 7,546 | 9.1 | 21.6 | 3,910 | 19.5 | 17,293 | 13.7 | 19.4 | |||
| Drug Initiation Year: 2010 | 7,146 | 18.5 | 9,084 | 11.0 | 18.5 | 3,610 | 18.0 | 16,869 | 13.4 | 18.0 | |||
| Drug Initiation Year: 2011 | 4,279 | 11.1 | 12,785 | 15.5 | 11.1 | 2,379 | 11.9 | 16,635 | 13.2 | 11.8 | |||
| Drug Initiation Year: 2012 | 2,262 | 5.8 | 14,440 | 17.5 | 5.9 | 1,392 | 6.9 | 16,930 | 13.4 | 6.9 | |||
| Drug Initiation Year: 2013 | 2,419 | 6.3 | 14,876 | 18.0 | 6.3 | 1,532 | 7.6 | 19,040 | 15.1 | 7.6 | |||
| Drug Initiation Year: 2014 | 2,333 | 6.0 | 14,447 | 17.5 | 6.0 | 1,603 | 8.0 | 17,837 | 14.1 | 8.0 | |||
| BLADDER COMORBIDITIES DURING BASELINE § | |||||||||||||
| Bladder Stones | 103 | 0.3 | 219 | 0.3 | 0.3 | 52 | 0.3 | 386 | 0.3 | 0.3 | |||
| Kidney Stones | 1,231 | 3.2 | 3,202 | 3.9 | 3.2 | 671 | 3.3 | 4,577 | 3.6 | 3.3 | |||
| Urinary Tract Infection | 9,545 | 24.7 | 24,107 | 29.2 | 24.6 | 5,176 | 25.8 | 35,116 | 27.8 | 25.9 | |||
| DIABETES-RELATED COMPLICATIONS DURING BASELINE § | |||||||||||||
| Nephropathy | 3,176 | 8.2 | 8,628 | 10.5 | 8.3 | 1,539 | 7.7 | 9,414 | 7.5 | 7.8 | |||
| Neuropathy | 7,437 | 19.2 | 19,216 | 23.3 | 19.6 | 3,624 | 18.1 | 21,696 | 17.2 | 18.1 | |||
| Retinopathy | 6,593 | 17.0 | 14,293 | 17.3 | 17.1 | 2,991 | 14.9 | 15,060 | 11.9 | 14.9 | |||
| HEALTHCARE UTILIZATION OR SMOKING-RELATED ENCOUNTER DURING BASELINE § | |||||||||||||
| Any Admission | 9,954 | 25.7 | 25,816 | 31.3 | 25.4 | 5,127 | 25.5 | 44,433 | 35.2 | 25.6 | |||
| Any Long-term Admission | 1,029 | 2.7 | 2,465 | 3.0 | 2.6 | 537 | 2.7 | 4,761 | 3.8 | 2.7 | |||
| Any Short-term Admission | 9,447 | 24.4 | 24,776 | 30.0 | 24.2 | 4,879 | 24.3 | 42,301 | 33.5 | 24.4 | |||
| Any SNF Admission | 2,940 | 7.6 | 8,305 | 10.1 | 7.5 | 1,547 | 7.7 | 15,420 | 12.2 | 7.8 | |||
| Any Electrocardiogram | 19,935 | 51.5 | 49,468 | 59.9 | 51.3 | 10,550 | 52.6 | 73,158 | 58.0 | 52.5 | |||
| Any Office Visit | 36,672 | 94.8 | 79,327 | 96.1 | 95.0 | 18,970 | 94.5 | 117,367 | 93.1 | 94.4 | |||
| Any Influenza Shot | 20,308 | 52.5 | 46,497 | 56.3 | 53.1 | 10,657 | 53.1 | 66,792 | 53.0 | 53.0 | |||
| Any Lipid Panel | 32,584 | 84.2 | 71,134 | 86.2 | 84.6 | 16,795 | 83.7 | 98,445 | 78.1 | 83.7 | |||
| Any PSA Test (men) | 9,493 | 58.3 | 18,042 | 56.9 | 58.4 | 4,946 | 59.2 | 26,542 | 51.6 | 59.2 | |||
| Any Colonoscopy | 3,787 | 9.8 | 8,491 | 10.3 | 9.8 | 2,026 | 10.1 | 12,453 | 9.9 | 10.1 | |||
| Any Mammogram (women) | 7,583 | 33.8 | 17,525 | 34.5 | 34.3 | 4,008 | 34.2 | 23,445 | 31.4 | 34.0 | |||
| Any Pap Smear (women) | 3,367 | 8.7 | 7,403 | 9.0 | 8.7 | 1,776 | 8.8 | 10,324 | 8.2 | 8.9 | |||
| Any Blood Test | 2,017 | 9.0 | 4,417 | 8.7 | 9.1 | 1,146 | 9.8 | 5,565 | 7.5 | 9.8 | |||
| Smoking** | 3,334 | 8.6 | 10,533 | 12.8 | 8.5 | 1,834 | 9.1 | 16,977 | 13.5 | 9.2 | |||
| OTHER COMORBIDITIES DURING BASELINE § | |||||||||||||
| Congestive Heart Failure | 6,648 | 17.2 | 20,971 | 25.4 | 17.1 | 3,479 | 17.3 | 32,491 | 25.8 | 17.3 | |||
| Chronic Kidney Disease | 5,051 | 13.1 | 13,402 | 16.2 | 13.0 | 2,600 | 13.0 | 19,373 | 15.4 | 13.0 | |||
| Connective Tissue Disease | 11,778 | 30.4 | 29,046 | 35.2 | 30.4 | 6,454 | 32.1 | 40,520 | 32.1 | 32.2 | |||
| COPD | 6,246 | 16.1 | 16,169 | 19.6 | 16.0 | 3,499 | 17.4 | 26,752 | 21.2 | 17.4 | |||
| Depression | 5,802 | 15.0 | 15,189 | 18.4 | 14.8 | 3,234 | 16.1 | 23,535 | 18.7 | 16.1 | |||
| Gastrointestinal Disorders | 308 | 0.8 | 808 | 1.0 | 0.8 | 196 | 1.0 | 1,243 | 1.0 | 1.0 | |||
| Infections | 16,802 | 43.4 | 40,235 | 48.7 | 43.3 | 8,989 | 44.8 | 58,534 | 46.4 | 44.8 | |||
| Myocardial Infarction | 319 | 0.8 | 1,026 | 1.2 | 0.8 | 142 | 0.7 | 1,630 | 1.3 | 0.7 | |||
| Stroke | 4,429 | 11.4 | 10,804 | 13.1 | 11.2 | 2,367 | 11.8 | 17,576 | 13.9 | 11.8 | |||
| History of Cancer†† | 7,489 | 19.4 | 19,836 | 24.0 | 19.4 | 4,046 | 20.2 | 29,856 | 23.7 | 20.1 | |||
| ANTIDIABETIC USE DURING BASELINE § | |||||||||||||
| DPP | 2,219 | 11.1 | 12,343 | 9.8 | 8.7 | ||||||||
| GLP-1 | 625 | 1.6 | 1,202 | 1.5 | 2.0 | 330 | 1.6 | 1,279 | 1.0 | 1.7 | |||
| Insulin | 6,474 | 16.7 | 15,526 | 18.8 | 16.7 | 4,258 | 21.2 | 18,544 | 14.7 | 21.2 | |||
| Short-acting Insulin | 4,186 | 10.8 | 9,537 | 11.6 | 10.7 | 2,847 | 14.2 | 12,198 | 9.7 | 14.2 | |||
| Long-acting Insulin | 3,901 | 10.1 | 10,041 | 12.2 | 10.1 | 2,575 | 12.8 | 10,915 | 8.7 | 12.8 | |||
| Meglitinides | 909 | 2.3 | 2,557 | 3.1 | 2.5 | 672 | 3.3 | 3,001 | 2.4 | 3.4 | |||
| Metformin | 18,532 | 47.9 | 42,485 | 51.5 | 48.0 | 8,784 | 43.8 | 55,033 | 43.6 | 43.8 | |||
| Sulfonylureas | 18,959 | 49.0 | 38,750 | 46.9 | 49.7 | ||||||||
| Other Antidiabetic ‡‡ | 308 | 0.80 | 737 | 0.89 | 124 | 0.62 | 510 | 0.40 | |||||
| MEDICATIONS DURING BASELINE § | |||||||||||||
| ACE Inhibitors | 14,332 | 37.0 | 29,477 | 35.7 | 36.9 | 6,476 | 32.3 | 42,145 | 33.4 | 32.2 | |||
| Anti-Cholesterol Drugs | 649 | 1.7 | 1,335 | 1.6 | 1.7 | 352 | 1.8 | 2,436 | 1.9 | 1.7 | |||
| ARBs | 5,573 | 14.4 | 14,254 | 17.3 | 14.5 | 2,979 | 14.8 | 16,520 | 13.1 | 14.9 | |||
| Beta-2 Antagonists | 3,095 | 8.0 | 7,849 | 9.5 | 7.9 | 1,704 | 8.5 | 12,404 | 9.8 | 8.4 | |||
| Bile Acid sequestrants | 419 | 1.1 | 1,311 | 1.6 | 1.1 | 274 | 1.4 | 1,565 | 1.2 | 1.4 | |||
| Beta-Blockers | 15,708 | 40.6 | 39,780 | 48.2 | 40.8 | 7,810 | 38.9 | 56,550 | 44.8 | 38.8 | |||
| CAIs | 1,308 | 3.4 | 3,060 | 3.7 | 3.5 | 734 | 3.7 | 3,396 | 2.7 | 3.7 | |||
| Calcium Channel Blockers | 10,863 | 28.1 | 25,282 | 30.6 | 28.1 | 5,277 | 26.3 | 35,605 | 28.2 | 26.3 | |||
| Estrogen | 517 | 1.3 | 1,071 | 1.3 | 1.4 | 296 | 1.5 | 1,554 | 1.2 | 1.5 | |||
| Fibrates | 3,225 | 8.3 | 6,803 | 8.2 | 8.6 | 1,556 | 7.8 | 8,286 | 6.6 | 7.8 | |||
| Glycosides | 2,018 | 5.2 | 5,446 | 6.6 | 5.2 | 979 | 4.9 | 8,787 | 7.0 | 4.9 | |||
| Loop Diuretics | 7,615 | 19.7 | 22,028 | 26.7 | 19.8 | 3,689 | 18.4 | 32,470 | 25.7 | 18.4 | |||
| Niacin | 692 | 1.8 | 1,320 | 1.6 | 1.8 | 399 | 2.0 | 1,441 | 1.1 | 2.0 | |||
| Non-loop Diuretics | 12,621 | 32.6 | 31,537 | 38.2 | 32.8 | 6,054 | 30.2 | 47,217 | 37.4 | 30.2 | |||
| Statins | 20,500 | 53.0 | 41,348 | 50.1 | 53.3 | 10,127 | 50.4 | 54,091 | 42.9 | 50.4 | |||
ACE, Angiotensin-converting enzyme inhibitor; ARB, Angiotensin receptor blockers; CAIs, Carbonic Anhydrase Inhibitors; COPD, Chronic Obstructive Pulmonary Disease; DPP, dipeptidyl-peptidase-4; GLP-1, glucagon-like peptide-1 receptor agonists; IQR, interquartile range; PIO, pioglitazone; PSA, Prostate-specific antigen; SMRW, Standardized morbidity ratio weighted; SNF, Skilled Nursing Facility; SU, sulfonylureas.
Number of people initiating PIO differs for each comparison due to exclusions of prior use of drugs included in comparison only.
Distribution of pseudo-population of people initiating SU or DPP treatment SMR-weighted to the distribution of covariates of those initiating PIO treatment, using the propensity score to balance covariates (and therefore control for confounding). N’s not reported.
Other race combines the following races as defined by Medicare: Other, Asian, Hispanic, or Native American
The baseline period was during the 12 months prior to drug initiation for comorbidities and healthcare utilization, and 6 months prior to drug initiation for medication history.
Smoking was defined using a previously validated algorithm that was a composite of tobacco use diagnosis codes or consultation CPT codes or prescription filled for smoking cessation. Although perfect specificity and PPV, this measure has poor sensitivity (27.9% [95% CI: 16.6–39.1%]31
History of cancer was evaluated during all available data prior to cohort entry.
Other antidiabetic medications included alpha-glucosidase inhibitors, amylin analogs, and sodium-glucose co-transporter 2 (SGLT2) inhibitors. These drugs were not included in the propensity score model as <1% combined in this study population.