Table 1.
Characteristics of patients ≥50 years old and free of dementia with an HbA1c between 6.5 and < 9.5 from the Veterans Health Administration (VHA; FY2002 to FY2012) and Kaiser Permanente Washington (KPW; 1996–2012) health care systemsa
| Covariates, mean(±sd) or n(%)b | VHA (n=112,845) | KPW (n=14,333) |
|---|---|---|
| Index year | ||
| 1996–1998 | - | 3653 (25.5) |
| 1999–2000 | - | 1629 (11.4) |
| 2001–2002 | - | 1457 (10.2) |
| 2002–2004 | 13479 (11.9) | - |
| 2003–2004 | - | 1539 (10.7) |
| 2005–2006 | 36461 (32.3) | 1941 (13.5) |
| 2007–2008 | 26859 (23.8) | 1639 (11.4) |
| 2009–2012 | - | 2475 (17.3) |
| 2009–2010 | 22676 (20.1) | - |
| 2011–2012 | 13370 (11.9) | - |
| Sociodemographic-related | ||
| Age (y) | 62.6 (±9.0) | 63.7 (±9.8) |
| Age category | ||
| 50–64 y | 65532 (58.1) | 8232 (57.4) |
| 65–74 y | 33167 (29.4) | 3711 (25.9) |
| ≥ 75 y | 14146 (12.5) | 2390 (16.7) |
| Male gender | 109220 (96.8) | 6971 (48.6) |
| Race | ||
| White | 92425 (81.9) | 10542 (73.6) |
| Black | 18206 (16.1) | 695 (4.9) |
| Asian | -- | 1183 (8.3) |
| Other | 2214 (2.0) | 415 (2.9) |
| Unknown | -- | 1498 (10.5) |
| Race (excluding unknown) | ||
| White | -- | 10542 (82.1) |
| Black | -- | 695 (5.4) |
| Asian | -- | 1183 (9.2) |
| Other | -- | 415 (3.2) |
| Missing race data | 0 (0) | 1498 (10.5) |
| Married | 68404 (60.6) | - |
| Low nSESc | 56422 (50.0) | 7065 (49.3) |
| VHA only insurance | 47440 (42.0) | - |
| Medicaid/Medicare | - | 6060 (42.3) |
| High healthcare utilization | 28211 (25.0) | 3559 (24.8) |
| Diabetes-related | ||
| HbA1c value | 6.9 (±0.5) | 7.1 (±0.7) |
| HbA1c category | ||
| 6.5 to < 7.0 | 80255 (71.1) | 8028 (56.0) |
| 7.0 to < 7.5 | 19204 (17.0) | 2996 (20.9) |
| 7.5 to < 8.0 | 7048 (6.3) | 1488 (10.4) |
| 8.0 to < 8.5 | 3237 (2.9) | 881 (6.2) |
| 8.5 to < 9.0 | 1920 (1.7) | 569 (4.0) |
| 9.0 to < 9.5 | 1181 (1.1) | 371 (2.6) |
| Creatinine value | 1.0 (±0.2) | 0.9 (±0.2) |
| Other comorbidities | ||
| Obesity | 60277 (53.4) | 6370 (44.4) |
| Hypertension | 101308 (89.8) | 7708 (53.8) |
| Hyperlipidemia | 96157 (85.2) | 4563 (31.8) |
| Stroke | 7319 (6.5) | 244 (1.7) |
| Ischemic heart disease | 54731 (48.5) | 2283 (15.9) |
| Congestive heart failure | 19594 (17.4) | 859 (6.0) |
| Atrial fibrillation | 16219 (14.4) | 939 (6.6) |
| Traumatic brain injury | 6074 (5.4) | 163 (1.1) |
| Vitamin B12 deficiency | 5390 (4.8) | 119 (0.8) |
| Psychiatric and substance comorbidities | ||
| Depression | 26943 (23.9) | 543 (3.8) |
| PTSD | 17198 (15.2) | 41 (0.3) |
| Other anxietyd | 13253 (11.7) | 337 (2.4) |
| Bipolar disorder | 7187 (6.4) | 168 (1.2) |
| Schizophrenia | 5662 (5.0) | 31 (0.2) |
| Nicotine abuse/dependence | 56414 (50.0) | 2182 (15.2) |
| Alcohol abuse/dependence | 15627 (13.9) | 241 (1.7) |
| Illicit drug abuse/dependence | 7889 (7.0) | 66 (0.5) |
| Other medications e | ||
| Statins | 77221 (68.4) | 3699 (25.8) |
| Anticholinergic drugs | 45758 (40.6) | 3170 (22.1) |
| NSAIDs | 57696 (51.1) | 2729 (19.0) |
| Antihypertensive drugs | 98087 (86.9) | 8875 (61.9) |
FY = fiscal year; HbA1c = hemoglobin A1c; nSES = neighborhood socioeconomic status; NSAID = nonsteroidal anti-inflammatory drug; PTSD = posttraumatic stress disorder.
VHA measures covariates from start of FY00 to index HbA1c while KPW measures from 2 years prior and up to index HbA1c.
Low nSES = top 50th percentile of factor score from 7 measures obtained from 2009–2013 5-year census estimates from the American Community Survey.
Other anxiety disorders = panic disorder, obsessive-compulsive disorder, social phobia, generalized anxiety disorder, anxiety NOS.
Other medications associated with dementia = sustained use on or before index HbA1c (≥2 fills in a 6-mo period).