Table 4.
Cost multipliers and associated 95% CIs for patient demographics, comorbidities, diabetes-related complications, antidiabetic drug exposure, and death: sensitivity analysis 1 (subtypes of diseases)
| Variable | Multiplier | 95% CI | |
|---|---|---|---|
| Baseline annual health care cost (2017 U.S. $), mean (95% CI) | 293.04 | 290.99 | 295.10 |
| Age at T2D diagnosis (years) (ref. <50) | |||
| 50–59 | 1.20 | 1.19 | 1.20 |
| 60–69 | 1.45 | 1.44 | 1.45 |
| ≥70 | 1.73 | 1.72 | 1.74 |
| Diabetes duration, years (ref. 1–4) | |||
| ≥5 | 0.86 | 0.86 | 0.86 |
| Female (ref. male) | 1.06 | 1.06 | 1.07 |
| Comorbidity (ref. none) | |||
| Hypertension | 1.19 | 1.19 | 1.20 |
| Hyperlipidemia | 1.06 | 1.05 | 1.06 |
| Liver disease | 0.97 | 0.96 | 0.97 |
| Cancer | 1.04 | 1.03 | 1.04 |
| Depression | 1.82 | 1.81 | 1.83 |
| Oral antidiabetic drug exposure (ref. none) | 1.80 | 1.79 | 1.80 |
| Injectable antidiabetic drug exposure (ref. none) | 1.76 | 1.75 | 1.77 |
| Complication (event year) (ref. none) | |||
| Stroke | |||
| Ischemic stroke | 2.57 | 2.54 | 2.59 |
| Hemorrhagic stroke | 4.76 | 4.66 | 4.87 |
| Transient ischemic attack | 1.46 | 1.44 | 1.49 |
| Myocardial infarction | 2.45 | 2.41 | 2.50 |
| Ischemic heart disease | 2.50 | 2.48 | 2.52 |
| Heart failure | 2.03 | 2.00 | 2.06 |
| Arteriosclerotic CVD | 1.87 | 1.68 | 2.07 |
| Arrhythmia | 2.03 | 2.01 | 2.06 |
| Nephropathy | |||
| CKD with or without short-term dialysis | 1.54 | 1.53 | 1.56 |
| ESRD with dialysis | 3.01 | 2.94 | 3.09 |
| Proteinuria | 1.20 | 1.19 | 1.21 |
| Kidney transplant | 2.29 | 1.94 | 2.72 |
| Other nephropathy | 1.48 | 1.47 | 1.50 |
| Retinopathy | |||
| Proliferative retinopathy | 1.80 | 1.78 | 1.82 |
| Blindness | 1.66 | 1.57 | 1.75 |
| Other retinopathy | 1.34 | 1.34 | 1.35 |
| Neuropathy | 1.41 | 1.41 | 1.42 |
| Peripheral vascular disease | |||
| Diabetes foot ulcer | 1.67 | 1.65 | 1.69 |
| Upper-extremity amputation | 3.79 | 3.49 | 4.11 |
| Lower-extremity amputation | 3.22 | 3.11 | 3.33 |
| Other peripheral vascular disease | 1.46 | 1.45 | 1.46 |
| Hospitalized diabetic ketoacidosis | 1.94 | 1.91 | 1.98 |
| Hospitalized HHS | 1.73 | 1.69 | 1.76 |
| Hospitalized hypoglycemia | 1.73 | 1.71 | 1.74 |
| Complication (state year) (ref. none) | |||
| Stroke | |||
| Ischemic stroke | 1.37 | 1.36 | 1.38 |
| Hemorrhagic stroke | 1.48 | 1.45 | 1.51 |
| Transient ischemic attack | 1.03 | 1.02 | 1.05 |
| Myocardial infarction | 1.16 | 1.14 | 1.18 |
| Ischemic heart disease | 1.31 | 1.30 | 1.32 |
| Heart failure | 1.24 | 1.22 | 1.25 |
| Arteriosclerotic CVD | 1.17 | 1.08 | 1.28 |
| Arrhythmia | 1.17 | 1.16 | 1.18 |
| Nephropathy | |||
| CKD with or without short-term dialysis | 1.09 | 1.08 | 1.10 |
| ESRD with dialysis | 6.99 | 6.82 | 7.17 |
| Proteinuria | 1.03 | 1.02 | 1.04 |
| Kidney transplant | 1.04 | 0.89 | 1.21 |
| Other nephropathy | 1.07 | 1.07 | 1.08 |
| Retinopathy | |||
| Proliferative retinopathy | 1.27 | 1.26 | 1.29 |
| Blindness | 1.08 | 1.03 | 1.13 |
| Other retinopathy | 1.10 | 1.09 | 1.10 |
| Neuropathy | 1.13 | 1.13 | 1.14 |
| Peripheral vascular disease | |||
| Diabetes foot ulcer | 1.10 | 1.09 | 1.12 |
| Upper-extremity amputation | 1.16 | 1.08 | 1.25 |
| Lower-extremity amputation | 1.13 | 1.09 | 1.16 |
| Other peripheral vascular disease | 1.11 | 1.10 | 1.11 |
| Death (ref. none) | |||
| Fatal CVD | |||
| Fatal ischemic stroke | 8.28 | 7.75 | 8.84 |
| Fatal hemorrhagic stroke | 7.13 | 6.63 | 7.68 |
| Fatal myocardial infarction | 2.99 | 2.77 | 3.22 |
| Fatal ischemic heart disease | 4.21 | 3.90 | 4.55 |
| Fatal heart failure | 5.47 | 5.17 | 5.79 |
| Other-cause death | 13.85 | 13.66 | 14.04 |
In sensitivity analysis 1, stroke, nephropathy, retinopathy, peripheral vascular disease, and fatal CVD were divided into subtypes of diseases. All variables in the model were statistically significant at P < 0.05, except kidney transplant (state year) (P = 0.521). Injectable antidiabetic drugs included insulin and glucagon-like peptide 1 receptor agonists. Fatal CVD was a composite end point of death as a result of stroke, myocardial infarction, ischemic heart disease, or heart failure. All variables were treated as time-dependent variables in the model, except age and sex. Hypertension, hyperlipidemia, liver disease, and cancer were considered as chronic diseases and assumed to be irreversible once they occurred, so the status of these comorbidities remained in the subsequent follow-up years. Depression status could be in and out, depending on whether patients had a diagnosis in a given year. CKD, chronic kidney disease; HHS, hyperosmolar hyperglycemic syndrome; ref., reference.