Table 1.
Characteristics of second-generation sulfonylurea users in Medicaid and Optum.
| Medicaid | Optum | ||
|---|---|---|---|
| Users, N | 624,406 | 491,940 | |
| Person-years of follow-up, sum, among all users | 201,183 | 197,848 | |
| Days of follow-up, median (5th, 95th percentile), per user | 46 (1, 428) | 76 (3, 532) | |
| Proportion of follow-up time covered by days’ supply of sulfonylurea dispensings, median (5th, 95th percentile) | 87.1 (67.4, 100.0) | 88.3 (67.4, 100.0) | |
| Demographics | Group | % (unless otherwise noted) | |
| Age, in years, at cohort entry | Median (Q1-Q3) | 57.8 (48.1–67.1) | 58.2 (49.8–66.8) |
| Sex | Female | 59.8 | 43.9 |
| Race/Ethnicity | White | 34.6 | 56.9 |
| Black | 18.7 | 13.3 | |
| Hispanic/Latino | 23.7 | 15.4 | |
| Asian | 6.4 | 3.7 | |
| Unknown/Missing/Other | 16.6 | 10.7 | |
| State of residence | CA | 45.0 | unavailable |
| FL | 11.9 | ||
| NY | 27.1 | ||
| OH | 8.8 | ||
| PA | 7.2 | ||
| Census level | New England | 0.0 | 2.6 |
| Middle Atlantic | 34.3 | 4.8 | |
| East North Central | 8.8 | 13.1 | |
| West North Central | 0.0 | 8.1 | |
| South Atlantic | 11.9 | 27.6 | |
| East South Central | 0.0 | 4.7 | |
| West South Central | 0.0 | 16.5 | |
| Mountain | 0.0 | 6.8 | |
| Pacific | 45.0 | 15.2 | |
| Unknown | 0.0 | 0.6 | |
| Education level | Less than 12th Grade | unavailable | 1.9 |
| High School Diploma | 37.4 | ||
| Less than Bachelor Degree | 44.9 | ||
| Bachelor Degree Plus | 7.7 | ||
| Unknown | 8.1 | ||
| Housing | Probable Homeowner | unavailable | 69.1 |
| Unknown | 30.9 | ||
| Household income | <$40K | unavailable | 18.1 |
| $40K-$49K | 6.9 | ||
| $50K-$59K | 6.6 | ||
| $60K-$74K | 8.5 | ||
| $75K-$99K | 10.8 | ||
| $100K + | 16.9 | ||
| Unknown | 32.1 | ||
| Total net worth of the primary customer | <$25K | unavailable | 11.3 |
| $25K-$149K | 21.3 | ||
| $150K-$249K | 14.5 | ||
| $250K-$499K | 21.6 | ||
| $500K + | 14.5 | ||
| Unknown | 16.8 | ||
| Calendar year of cohort entry‡ | 2000 | 6.3 | - |
| 2001 | 7.6 | 3.3 | |
| 2002 | 7.8 | 4.1 | |
| 2003 | 7.6 | 3.9 | |
| 2004 | 6.3 | 4.1 | |
| 2005 | 8.1 | 12.6 | |
| 2006 | 11.2 | 6.9 | |
| 2007 | 7.6 | 6.2 | |
| 2008 | 6.3 | 7.4 | |
| 2009 | 7.1 | 6.4 | |
| 2010 | 8.4 | 6.6 | |
| 2011 | 7.4 | 6.9 | |
| 2012 | 8.3 | 6.8 | |
| 2013 | unavailable | 6.5 | |
| 2014 | 5.6 | ||
| 2015 | 6.0 | ||
| 2016 | 6.5 | ||
| Medicare enrolled | Yes | 48.7 | 30.5 |
| Nursing home residence ever during baseline | Yes | 6.0 | 1.3 |
| Healthcare use intensity measures, in baseline period* | Group | Measure of central tendency | |
| No. prescriptions dispensed, total | Median (Q1-Q3) | 37.0 (9.0–78.0) | 19.0 (4.0–41.0) |
| No. prescriptions dispensed, by unique drug | Median (Q1-Q3) | 11.0 (5.0–19.0) | 6.0 (3.0–11.0) |
| No. outpatient diagnosis codes, total | Median (Q1-Q3) | 29.0 (10.0–69.0) | 19.0 (6.0–40.0) |
| No. outpatient diagnosis codes, by unique code | Median (Q1-Q3) | 11.0 (5.0–21.0) | 10.0 (4.0–16.0) |
| No. outpatient CPT-4/HCPCS codes, total | Median (Q1-Q3) | 34.0 (12.0–78.0) | 21.0 (7.0–42.0) |
| No. outpatient CPT-4/HCPCS codes, by unique code | Median (Q1-Q3) | 21.0 (9.0–40.0) | 14.0 (6.0–26.0) |
| Other investigator pre-defined covariates, in baseline period | Group | % | |
| Disorders of lipid metabolism | Yes | 42.5 | 56.7 |
| Rheumatic heart disease, chronic | Yes | 2.3 | 1.2 |
| Hypertensive disease | Yes | 57.9 | 60.5 |
| Ischemic heart disease | Yes | 20.9 | 14.3 |
| Conduction disorders | Yes | 2.0 | 1.6 |
| Heart failure/cardiomyopathy | Yes | 12.8 | 5.9 |
| Cardiomegaly | Yes | 5.8 | 3.0 |
| Congenital anomalies of the heart, other | Yes | 1.3 | 0.4 |
| Implantable cardioverter defibrillator/pacemaker use | Yes | 0.9 | 0.8 |
| Kidney disease | Yes | 16.2 | 13.6 |
| Depression | Yes | 24.6 | 13.9 |
| Obesity | Yes | 11.7 | 14.1 |
| Tobacco use | Yes | 8.6 | 8.9 |
| Alcohol abuse | Yes | 3.3 | 1.3 |
| Hypoglycemia, serious | Yes | 2.2 | 0.6 |
| Diabetes mellitus, type 2† | Yes | 95.1 | 97.9 |
| Adapted Diabetes Complications Severity Index | 0 | 50.7 | 61.1 |
| 1 | 12.5 | 14.1 | |
| 2 | 14.6 | 12.0 | |
| 3 | 6.8 | 5.1 | |
| 4 | 5.8 | 3.5 | |
| 5+ | 9.5 | 4.1 | |
| Drugs in the 30 days prior to cohort entry** | Group | % | |
| alpha-glucosidase inhibitor | Yes | 0.3 | 0.1 |
| amylin analog | Yes | 0.0 | 0.0 |
| dipeptidyl peptidase-4 inhibitor | Yes | 1.9 | 3.6 |
| glucagon-like peptide-1 receptor agonist | Yes | 0.2 | 1.0 |
| insulin | Yes | 7.8 | 3.8 |
| metformin | Yes | 22.3 | 24.4 |
| meglitinide | Yes | 1.0 | 0.4 |
| sodium-glucose co-transporter 2 inhibitor§ | Yes | 0.0 | 0.3 |
| thiazolidinedione | Yes | 7.8 | 5.5 |
| CYP2C9 inhibitor | Yes | 4.8 | 2.7 |
| CYP3A4 inhibitor | Yes | 3.7 | 2.1 |
| CYP2C9 inducer | Yes | 0.9 | 0.2 |
| CYP3A4 inducer | Yes | 6.2 | 3.7 |
| drug with known risk of TdP§§ | Yes | 9.0 | 6.3 |
| drug with known, possible, or conditional risk of TdP§§ | Yes | 44.9 | 32.1 |
| ≥ 5 prescription dispensings for unique drugs | Yes | 39.9 | 21.7 |
| Laboratory covariates, in baseline period | Group | % | |
| Blood glucose | No lab ever in past | unavailable | 51.2 |
| No lab in 1-year baseline | 23.5 | ||
| Normal | 8.2 | ||
| Low abnormal | 0.2 | ||
| High abnormal | 16.9 | ||
| Hemoglobin A1C | No lab ever in past | 51.2 | |
| No lab in 1-year baseline | 26.0 | ||
| Normal | 6.0 | ||
| Low abnormal | 0.0 | ||
| High abnormal | 16.8 | ||
| Serum creatinine | No lab ever in past | 51.2 | |
| No lab in 1-year baseline | 23.3 | ||
| Normal | 19.5 | ||
| Low abnormal | 3.4 | ||
| High abnormal | 2.5 | ||
| Hematocrit | No lab ever in past | 51.2 | |
| No lab in 1-year baseline | 30.4 | ||
| Normal | 16.2 | ||
| Low abnormal | 1.9 | ||
| High abnormal | 0.2 | ||
| Hemoglobin | No lab ever in past | 51.2 | |
| No lab in 1-year baseline | 30.5 | ||
| Normal | 15.7 | ||
| Low abnormal | 2.2 | ||
| High abnormal | 0.4 | ||
| Hypoglycemia, laboratory measured, alert value | No lab ever in past | 51.2 | |
| No lab in 1-year baseline | 23.5 | ||
| No alert value | 24.8 | ||
| Alert value | 0.5 | ||
| Hypoglycemia, laboratory measured, clinically significant value | No lab ever in past | 51.2 | |
| No glucose in 1-year baseline | 23.5 | ||
| No clinically significant value | 25.2 | ||
| Clinically significant value | 0.2 | ||
CA = California; CPT = Current Procedural Terminology; CYP = cytochrome P450; FL = Florida; HCPCS = Healthcare Common Procedure Coding System; ICD = International Classification of Diseases; NY = New York; OH = Ohio; PA = Pennsylvania; Q = quartile; TdP = torsade de pointes
See Supplementary Table 1 and Supplementary Table 2 for intra-database comparisons of characteristics by individual sulfonylurea.
*The following healthcare utilization covariates were excluded from presentation in the table, as their median values were zero for each sulfonylurea: #inpatient ICD-9 diagnosis codes; #unique inpatient ICD-9 diagnosis codes; #inpatient ICD-9 procedure codes; #unique inpatient ICD-9 procedure codes; #inpatient CPT/HCPCS procedure codes; #unique inpatient CPT/HCPCS procedure codes; #outpatient ICD-9 procedure codes; #unique outpatient ICD-9 procedure codes; #other setting ICD-9 diagnosis codes; #unique other setting ICD-9 diagnosis codes; #other setting ICD-9 procedure codes; #unique other setting ICD-9 procedure codes; #laboratory LOINC codes (Optum only); #unique laboratory LOINC codes (Optum only).
**Antimicrobial drugs in each category were examined within 14 (rather than 30) days prior to cohort entry; these agents are typically prescribed for acute conditions.
†Defined by ratio of type 1 (e.g., ICD-9 250.X1 or 250.X3) to type 2 (e.g., ICD-9 250.X0 or 250.X2) codes ≤0.5, ascertained during baseline and on cohort entry date.
‡Prespecified covariate not forced into propensity score, but included as a categorical variable in outcome model.
§Not marketed during years of study in Medicaid analysis.
§§Per CredibleMeds (AZCERT Inc.: Oro Valley, AZ).