Table 5.
Multivariable analysis of factors associated with insulin discontinuation
| Characteristic | Labs Multiply Imputed (7009 patients) |
Labs Not Included (7009 patients) |
Patients with Missing Labs Not Included (2790 patients) |
|||
|---|---|---|---|---|---|---|
| OR (95% CI) | P-value | OR (95% CI) | P-value | OR (95% CI) | P-value | |
| Age | 0.99 (0.99–0.99) | 0.022 | 0.99 (0.99–0.99) | 0.02 | 0.99 (0.99–1.01) | 0.44 |
| Female | 1.1 (0.95–1.2) | 0.28 | 1.1 (0.95–1.2) | 0.28 | 1.02 (0.85–1.2) | 0.83 |
| Race | ||||||
| African-American | 0.98 (0.84–1.2) | 0.83 | 0.98 (0.84–1.2) | 0.83 | 0.81 (0.62–1.06) | 0.12 |
| Asian | 1.1 (0.86–1.5) | 0.41 | 1.1 (0.86–1.5) | 0.41 | 0.98 (0.67–1.4) | 0.91 |
| Hispanic | 0.95 (0.80–1.1) | 0.55 | 0.95 (0.80–1.1) | 0.55 | 0.93 (0.70–1.2) | 0.62 |
| Other | 1.1 (0.87–1.3) | 0.55 | 1.1 (0.87–1.3) | 0.55 | 1.1 (0.80–1.4) | 0.62 |
| Married | 1.01 (0.91–1.1) | 0.79 | 1.01 (0.91–1.1) | 0.79 | 1.02 (0.86–1.2) | 0.85 |
| Median household income by zip code | 1.00 (1.00–1.00) | 0.21 | 1.00 (1.00–1.00) | 0.21 | 1.02 (1.00–1.1) | 0.32 |
| Smoking history | 1.01 (0.91–1.1) | 0.87 | 1.01 (0.91–1.1) | 0.87 | 1.1 (0.93–1.3) | 0.27 |
| CAD | 0.98 (0.86–1.1) | 0.78 | 0.98 (0.86–1.1) | 0.78 | 1.01 (0.82–1.3) | 0.92 |
| Stroke | 1.3 (1.0–1.7) | 0.02 | 1.3 (1.0–1.7) | 0.02 | 1.7 (1.2–2.5) | 0.0017 |
| PVD | 0.83 (0.68–1.02) | 0.08 | 0.83 (0.68–1.02) | 0.08 | 0.78 (0.58–1.1) | 0.11 |
| HTN | 0.96 (0.84–1.1) | 0.61 | 0.96 (0.84–1.1) | 0.61 | 0.84 (0.67–1.1) | 0.16 |
| Depression | 1.03 (0.90–1.2) | 0.70 | 1.03 (0.90–1.2) | 0.70 | 0.12 (0.97–1.4) | 0.10 |
| Bipolar | 1.25 (0.91–1.7) | 0.17 | 1.25 (0.91–1.7) | 0.17 | 1.3 (0.83–2.1) | 0.24 |
| Schizophrenia | 0.84 (0.53–1.3) | 0.44 | 0.84 (0.53–1.3) | 0.44 | 0.75 (0.39–1.5) | 0.40 |
| Hypoglycemia | 0.99 (0.63–1.6) | 0.98 | 0.99 (0.63–1.6) | 0.98 | 0.66 (0.31–1.4) | 0.30 |
| CCI | 1.03 (1.01–1.05) | 0.003 | 1.03 (1.01–1.05) | 0.003 | 1.01 (0.98–1.04) | 0.62 |
| BMI Increase | 0.61 (0.50–0.74) | < 0.001 | 0.61 (0.50–0.74) | < 0.001 | 0.57 (0.43–0.77) | 0.0003 |
| Number of DM non-insulin meds | 0.97 (0.92–1.02) | 0.27 | 0.97 (0.92–1.02) | 0.27 | 0.99 (0.91–1.1) | 0.95 |
| Number of non-DM meds | 1.01 (1.00–1.03) | 0.04 | 1.01 (1.00–1.03) | 0.04 | 1.01 (0.99–1.03) | 0.32 |
| Adverse Reactions to non-insulin meds | 1.00 (0.98–1.02) | 0.91 | 1.00 (0.98–1.02) | 0.91 | 0.99 (0.96–1.03) | 0.78 |
| SBP | 1.00 (0.99–1.00) | 0.93 | 1.00 (0.99–1.00) | 0.93 | 1.00 (0.99–1.01) | 0.26 |
| DBP | 0.99 (0.99–1.00) | 0.99 | 0.99 (0.99–1.00) | 0.99 | 0.99 (0.99–1.01) | 0.90 |
| HbA1c | 1.06 (1.02–1.1) | 0.005 | 1.1 (1.05–1.1) | < 0.001 | ||
| LDL | 0.99 (0.99–1.00) | 0.71 | 1.00 (0.99–1.00) | 0.98 | ||
| eGFR | 1.00 (0.99–1.00) | 0.31 | 1.00 (0.99–1.01) | 0.65 | ||
| Encounter frequency | 0.99 (0.98–0.996) | 0.004 | 0.99 (0.98–0.996) | 0.004 | 0.99 (0.98–1.01) | 0.25 |
| Nurse practitioner | 0.90 (0.77–1.04) | 0.16 | 0.90 (0.77–1.04) | 0.16 | 0.69 (0.44–1.1) | 0.10 |
| Provider specialty | ||||||
| Endocrinology | 2.6 (2.2–3.0) | < 0.001 | 2.6 (2.2–3.0) | < 0.001 | 2.0 (1.6–2.6) | < 0.001 |
| Other | 1.3 (1.1–1.5) | < 0.001 | 1.3 (1.1–1.5) | < 0.001 | 1.1 (0.88–1.4) | 0.44 |
| Provider female | 1.2 (1.1–1.4) | < 0.001 | 1.2 (1.1–1.4) | < 0.001 | 1.2 (1.00–1.4) | 0.044 |
| Provider diabetes experiencea | 0.93 (0.90–0.96) | < 0.001 | 0.93 (0.90–0.96) | < 0.001 | 0.97 (0.93–1.02) | 0.24 |
| Insulin regimenb | ||||||
| Basal-bolus | 1.6 (1.3–1.8) | < 0.001 | 1.6 (1.3–1.8) | < 0.001 | 1.5 (1.1–2.0) | 0.003 |
| Bolus only | 1.2 (1.04–1.4) | 0.01 | 1.2 (1.04–1.4) | 0.01 | 1.2 (0.91–1.5) | 0.22 |
| Mixed | 1.2 (0.92–1.6) | 0.16 | 1.2 (0.92–1.6) | 0.16 | 1.3 (0.88–2.0) | 0.18 |
| Commercial EMR | 0.53 (0.40–0.71) | < 0.001 | 0.53 (0.40–0.71) | < 0.001 | 0.68 (0.45–1.04) | 0.08 |
Labs Multiply Imputed represents the model (primary analysis) where all patients were included and missing HbA1c, LDL and eGFR data were accounted for by multiple imputation
Labs Not Included represents the model where all patients were included but HbA1c, LDL and eGFR variables were not included in the model
Patients with Missing Labs Not Included represents the model where patients who missing either HbA1c, LDL or eGFR data were not included in the model (2790 patients were included)
aPer 100 patients seen annually
bCompared to basal insulin regimen