The prevalence of cardiovascular disease and antidiabetes treatment characteristics among a large type 2 diabetes population in the United States

Weng, Wayne; Tian, Ye; Kong, Sheldon X.; Ganguly, Rahul; Hersloev, Malene; Brett, Jason; Hobbs, Todd

doi:10.1002/edm2.76

Cited by 44 publications

(51 citation statements)

References 19 publications

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“…The leading cause of death in people with T2DM is CVD, therefore prevention of cardiovascular events is a key focus in the management of T2DM patients [1]. Several observational studies have shown that the use of antidiabetic drugs with demonstrated cardiovascular benefits in these patients is far from optimal, even in patients controlled by specialists [17,18]. This was also the case in our study: SGLT2i and GLP1ra were infrequently prescribed in patients with CVD (2.6% and 1.4%, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…Despite scientific evidence from a number of cardiovascular outcome trials (CVOTs) [7][8][9] and the guideline recommendations [2][3][4][5][6], adequate management of these patients remains beset with challenges. Several observational studies performed around the world report a gap between guideline recommendations and daily clinical practice [10][11][12][13][14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of clinical and antidiabetic treatment characteristics of different sub-groups of patients with type 2 diabetes: Data from a Mediterranean population database

Mata-Cases

Franch-Nadal

Real

et al. 2021

Primary Care Diabetes

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Aims: To describe the characteristics and antidiabetic treatment among type 2 diabetes patients according to the clinical conditions prioritized in the Spanish 2020 RedGDPS (Primary Care Diabetes Study Groups Network) therapeutic algorithm: obesity, older than 75 years, chronic kidney disease, cardiovascular disease, and heart failure. Methods: Retrospective, cross-sectional study. Clinical characteristics, the use of antidiabetic drugs and the KDIGO renal risk categories at 31.12.2016 were retrieved from the SIDIAP (Information System for Research in Primary Care) database (Catalonia, Spain). Results: From a total of 373,185 type 2 diabetes patients, 37% were older than 75 years, 45% obese, 33% had chronic kidney disease, 23.2% cardiovascular disease and 6.9% heart failure. Insulin was more frequently prescribed in chronic kidney disease, cardiovascular disease and heart failure whereas Sodium-Glucose cotransporter 2 inhibitors and Glucagon Like Peptide 1 receptor agonists were scarcely prescribed (2.6% and 1.4%, respectively). Among patients with severe renal failure, contraindicated drugs like metformin (16%) and sulfonylureas (6.1%) were still in use. The 2012 KDIGO renal risk categories distribution was: Low: 60.9%, Moderate: 21.6%, High: 9.8% and Very high: 7.7%. Conclusions: Almost 80% of our T2DM patients meet one of the five clinical conditions that should be considered for treatment individualization. Importantly, a relevant number of patients with severe renal failure were found to use contraindicated drugs.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of clinical and antidiabetic treatment characteristics of different sub-groups of patients with type 2 diabetes: Data from a Mediterranean population database

Mata-Cases

Franch-Nadal

Real

et al. 2021

Primary Care Diabetes

View full text Add to dashboard Cite

show abstract

“…ASCVD was defined based on relevant ICD-9/-10 codes corresponding to diagnoses included in the ADA 2017 definition of ASCVD, including: acute coronary syndrome, history of MI, stable or unstable angina, peripheral arterial disease presumed to be of atherosclerotic origin, stroke, transient ischemic attack, and coronary or other arterial revascularization [17]. A detailed listing of relevant ICD-9/-10 codes has been provided elsewhere [15].…”

Section: Study Cohortsmentioning

confidence: 99%

“…The current study was designed to further the understanding of the impact of ASCVD on healthcare resource utilization and costs in patients with T2DM in the United States (US) using a large (1 million+) population identified within a national claims database. The clinical characteristics and antidiabetes treatment patterns of this population have been analyzed separately and reported elsewhere [15].…”

Section: Introductionmentioning

confidence: 99%

Impact of atherosclerotic cardiovascular disease on healthcare resource utilization and costs in patients with type 2 diabetes mellitus in a real-world setting

Weng

Tian

Kong

et al. 2020

Clin Diabetes Endocrinol

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Background: This study evaluated the impact of atherosclerotic cardiovascular disease (ASCVD) on healthcare resource utilization and costs in patients with type 2 diabetes mellitus (T2DM). Methods: This study was a retrospective, cross-sectional study using US claims data. Adult patients with T2DM were stratified by presence or absence of ASCVD and compared regarding annual (2015) healthcare resource utilization and associated costs. Subgroup analyses were conducted for three age groups (18-44, 45-64, and ≥ 65 years). Results: Among 1,202,596 eligible patients with T2DM, 45.2% had documented ASCVD. The proportions of patients with inpatient and ER-based resource utilization during 2015 were three-to-four times greater in the ASCVD cohort as compared to the non-ASCVD cohort for the categories of inpatient visits (15.6% vs 4.4% of patients), outpatient ER visits (18.4% vs 5.2% of patients), and inpatient ER visits (4.3% vs 0.9% of patients). Outpatient utilization also was higher among patients with ASCVD as compared to those without ASCVD (mean number of annual office visits per patient, 9.1 vs 5.6), and more than twice as many patients with ASCVD had ≥ 9 office visits (43.5% vs 19.8%). Average perpatient total healthcare cost was $22,977 for ASCVD vs $9735 for non-ASCVD, with medical costs primarily driving the difference ($17,849 vs $6079); the difference in pharmacy costs was smaller ($5128 vs $3656). In the 18-44, 45-64, and ≥ 65 age subgroups respectively, total annual healthcare costs were 143, 127, and 114% higher in ASCVD vs non-ASCVD patients. Conclusions: These findings indicate significantly higher healthcare resource utilization and associated costs in patients having T2DM with ASCVD compared to T2DM without ASCVD.

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“…The claims database population used in the current study has been described previously . Briefly, eligible individuals were aged ≥18 years on 1 January 2015 and had an established diagnosis of type 2 DM before 1 January 2015, defined as ≥2 diagnoses for type 2 DM, based on international classification of diseases, ninth revision (ICD‐9) codes of 250.×0 or 250.×2 or ICD‐10 codes of E11.xx or ≥1 type 2 DM diagnosis with ≥1 oral antidiabetes drug claim, and no more than 1 type 1 diabetes diagnosis according to ICD‐9 (250.×1, 250.×3) or ICD‐10 (E10.×) codes.…”

Section: Participants and Methodsmentioning

confidence: 99%

The prevalence of cardiovascular disease by vascular bed and impact on healthcare costs in a large, real‐world population with type 2 diabetes

Weng

Kong

Ganguly

et al. 2020

Endocrino Diabet & Metabol

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Introduction:The purpose of this study was to assess prevalence of atherosclerotic cardiovascular disease (ASCVD) according to number of affected vascular beds and the impact on healthcare utilization and costs in persons with type 2 diabetes mellitus (type 2 DM) and established ASCVD. Methods:In this retrospective, cross-sectional analysis, adults with type 2 DM and ASCVD in a large US administrative claims database were categorized by number of ASCVD-affected vascular beds (brain, heart, peripheral vasculature). Annual healthcare utilization and costs for 2015 were determined, including subgroup analyses by age group (18-44, 45-64, ≥65 years). Results:Among 539 089 individuals with type 2 DM and ASCVD, 47.0% had ASCVD affecting >1 vascular bed. The most prevalent ASCVD diagnoses were acute coronary syndrome (26.6%), peripheral arterial disease (24.5%) and stroke (18.6%). Mean annual total healthcare costs per person increased with increasing number of vascular beds, from 1 ($17 741) to 2 ($25 877) to 3 ($33 412). A similar pattern of increased healthcare utilization with increasing number of vascular beds was observed. Among individuals with 1 affected vascular bed, mean total healthcare costs per person were comparable across age subgroups; however, if >1 vascular bed was affected, the mean total healthcare costs were highest in the youngest age cohort. Conclusions:These real-world data showed that almost half of individuals with type 2 DM and ASCVD had ASCVD affecting >1 vascular bed. A higher number of affected vascular beds were associated with higher mean total healthcare costs and utilization, with a disproportionate increase noted in younger relative to older people. K E Y W O R D S atherosclerotic cardiovascular disease, cerebrovascular disorders, coronary disease, epidemiology, peripheral vascular diseases, type 2 diabetes mellitus, vascular diseases This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Additional supporting information may be found online in the Supporting Information section. How to cite this article: Weng W, Kong SX, Ganguly R, et al. The prevalence of cardiovascular disease by vascular bed and impact on healthcare costs in a large, real-world population with type 2 diabetes. Endocrinol Diab Metab. 2020;3:e00106.

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The prevalence of cardiovascular disease and antidiabetes treatment characteristics among a large type 2 diabetes population in the United States

Cited by 44 publications

References 19 publications

Evaluation of clinical and antidiabetic treatment characteristics of different sub-groups of patients with type 2 diabetes: Data from a Mediterranean population database

Evaluation of clinical and antidiabetic treatment characteristics of different sub-groups of patients with type 2 diabetes: Data from a Mediterranean population database

Impact of atherosclerotic cardiovascular disease on healthcare resource utilization and costs in patients with type 2 diabetes mellitus in a real-world setting

The prevalence of cardiovascular disease by vascular bed and impact on healthcare costs in a large, real‐world population with type 2 diabetes

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