Title

Persistence with rapid- acting insulin and its association with A1C level and severe hypoglycemia among elderly patients with type 2 diabetes

Document Type

Article

Publication Date

7-1-2017

Abstract

Objective—To examine the persistence with rapid-acting insulin (RAI) and its association with clinical outcomes among elderly patients with type 2 diabetes (T2D). Methods—This observational, retrospective cohort study analyzed RAI persistence and its association with change in A1C and risk of severe hypoglycemia among elderly (≥65 years) Medicare beneficiaries with T2D who added RAI to their basal insulin regimen. Results—Among T2D patients with >1 RAI prescriptions (n=3,927), only 21% were persistent. Baseline factors positively associated with RAI persistence (Adjusted Odds Ratio [95% CI]) were: age ≥75 vs 65–74 years: 1.20 [1.01–1.43]; use of ≥3 oral antidiabetes drugs: 1.63 [1.16–2.28]; cognitive impairment: 1.34 [1.03–1.73]; and A1C >9.0%: 1.58 [1.15–2.17]. Elderly T2D patients having emergency department visits (0.73 [0.59–0.91]) and higher RAI out-of-pocket costs (≥$75 vs $0 to

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