Table 3.
Factors associated with insulin and sulfonylurea use among US adults with diabetes
| Sulfonylurea (no insulin) | Insulin (±sulfonylurea) | |||
| OR (95% CI) | P value | OR (95% CI) | P value | |
| Age groups | ||||
| 18–44 years | Ref | Ref | ||
| 45–64 years | 1.09 (1.03 to 1.14) | 0.002 | 0.94 (0.89 to 0.99) | 0.03 |
| 65–74 years | 1.27 (1.20 to 1.34) | <0.001 | 0.72 (0.68 to 0.77) | <0.001 |
| ≥75 years | 1.36 (1.29 to 1.44) | <0.001 | 0.51 (0.48 to 0.54) | <0.001 |
| Gender | ||||
| Male | Ref | Ref | ||
| Female | 0.80 (0.78 to 0.82) | <0.001 | 1.10 (1.07 to 1.13) | <0.001 |
| Race | ||||
| White | Ref | Ref | ||
| Black | 1.01 (0.98 to 1.04) | 0.70 | 1.00 (0.97 to 1.04) | 0.89 |
| Hispanic | 1.18 (1.15 to 1.22) | <0.001 | 0.86 (0.83 to 0.89) | <0.001 |
| Asian | 1.23 (1.17 to 1.28) | <0.001 | 0.59 (0.55 to 0.62) | <0.001 |
| Unknown | 0.95 (0.90 to 1.00) | 0.06 | 0.76 (0.72 to 0.82) | <0.001 |
| Household income | ||||
| <$40 000 | Ref | Ref | ||
| $40 000–$49 999 | 1.00 (0.96 to 1.04) | 0.91 | 0.88 (0.84 to 0.92) | <0.001 |
| $50 000–$59 999 | 0.97 (0.94 to 1.01) | 0.19 | 0.88 (0.84 to 0.92) | <0.001 |
| $60 000–$74 999 | 0.93 (0.89 to 0.96) | <0.001 | 0.89 (0.85 to 0.93) | <0.001 |
| $75 000–$99 999 | 0.93 (0.90 to 0.97) | <0.001 | 0.84 (0.80 to 0.87) | <0.001 |
| ≥$100 000 | 0.85 (0.82 to 0.88) | <0.001 | 0.83 (0.80 to 0.86) | <0.001 |
| Unknown | 0.90 (0.85 to 0.94) | <0.001 | 0.97 (0.92 to 1.02) | 0.20 |
| HbA1c range | ||||
| ≤5.6% | 0.52 (0.49 to 0.56) | <0.001 | 0.43 (0.39 to 0.46) | <0.001 |
| 5.7%–6.4% | 0.60 (0.58 to 0.61) | <0.001 | 0.48 (0.46 to 0.50) | <0.001 |
| 6.5%–6.9% | Ref | Ref | ||
| 7.0%–7.9% | 1.46 (1.42 to 1.51) | <0.001 | 2.41 (2.32 to 2.50) | <0.001 |
| 8.0%–8.9% | 1.37 (1.32 to 1.42) | <0.001 | 5.21 (5.00 to 5.43) | <0.001 |
| 9.0%–9.9% | 1.13 (1.08 to 1.19) | <0.001 | 7.82 (7.43 to 8.23) | <0.001 |
| ≥10.0% | 0.99 (0.94 to 1.04) | 0.73 | 9.43 (8.97 to 9.90) | <0.001 |
| Type and degree of multimorbidity | ||||
| Concordant comorbidities | ||||
| 0 | Ref | Ref | ||
| 1 | 1.02 (0.99 to 1.06) | 0.24 | 1.45 (1.39 to 1.51) | <0.001 |
| 2 | 0.96 (0.92 to 1.00) | 0.03 | 2.79 (2.66 to 2.93) | <0.001 |
| ≥3 | 0.76 (0.73 to 0.79) | <0.001 | 5.50 (5.22 to 5.79) | <0.001 |
| Discordant comorbidities | ||||
| 0 | Ref | Ref | ||
| 1 | 0.89 (0.87 to 0.91) | <0.001 | 1.17 (1.14 to 1.20) | <0.001 |
| 2 | 0.76 (0.72 to 0.79) | <0.001 | 1.37 (1.31 to 1.43) | <0.001 |
| ≥3 | 0.70 (0.64 to 0.76) | <0.001 | 1.72 (1.60 to 1.86) | <0.001 |
| Advanced comorbidities | ||||
| 0 | Ref | Ref | ||
| 1 | 0.90 (0.87 to 0.93) | <0.001 | 1.24 (1.20 to 1.29) | <0.001 |
| ≥2 | 0.86 (0.74 to 1.01) | 0.06 | 1.45 (1.25 to 1.68) | <0.001 |
Two multivariable logistic regression analyses examined the odds of (1) sulfonylurea without insulin and (2) insulin with or without sulfonylurea use controlling for patient age, sex, race/ethnicity, annual household income, glycosylated hemoglobin (HbA1c) level, and type of comorbidity profile. In each model, comorbidity burden was reflected by the number of comorbidities within each comorbidity category (ie, diabetes concordant, discordant, and advanced).