Progression to type 2 diabetes, healthcare utilization, and cost among pre-diabetic patients with or without comorbid hypertension

Abstract Objective: This study examined progression to type 2 diabetes and compared healthcare utilization and costs among patients with pre-diabetes, with or without comorbid hypertension. Research design and methods: This study drew from a large national claims database (2003-2008). Patients were...

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Bibliographic Details
Published in:Current medical research and opinion 2011-04, Vol.27 (4), p.809-819
Main Authors: Francis, Bruce H., Song, Xue, Andrews, L. M., Purkayastha, Das, Princic, Nicole, Sedgley, Robert, Rudolph, Amy E.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Comorbidity
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - economics
Diabetes Mellitus, Type 2 - epidemiology
Disease Progression
Female
Health Care Costs
Health Resources - utilization
Healthcare costs
Healthcare utilization
Humans
Hypertension
Hypertension - complications
Hypertension - economics
Hypertension - epidemiology
Male
Middle Aged
Models, Statistical
Pre-diabetes
Prediabetic State - economics
Prediabetic State - epidemiology
Prediabetic State - pathology
Type 2 diabetes
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Summary:Abstract Objective: This study examined progression to type 2 diabetes and compared healthcare utilization and costs among patients with pre-diabetes, with or without comorbid hypertension. Research design and methods: This study drew from a large national claims database (2003-2008). Patients were 18 years of age with a medical claim or lab value indicating the presence of pre-diabetes. The index date was the first pre-diabetes diagnosis (ICD-9 codes 790.21, 790.22, 790.29) or qualifying lab value of fasting plasma glucose or impaired glucose intolerance. All patients had 12-month data pre- and post- index date. Multivariate analysis was conducted to identify risk factors affecting progression to type 2 diabetes, and to estimate the impact of hypertension status and diabetes progression on healthcare utilization and cost. Results: 144,410 patients met study criteria, with an average follow-up of 802 (SD 344) days. Among participants, 30.7% progressed to diabetes, with a mean 288 (SD 340) days from pre-diabetes identification to diabetes diagnosis. Compared with patients who did not progress, the total adjusted medical costs for patients who developed diabetes increased by $1429 in 1 year, $2451 in 2 years, and $3621 in 3 years (p 
ISSN:0300-7995
1473-4877
DOI:10.1185/03007995.2011.554806