Scholarlink

Introduction <p>This study examines the characteristics of adults with type&#xa0;2 diabetes (T2D) who were not initially treated with an antihyperglycemic agent (AHA).</p> Methods <p>The analyses used Optum de-identified Market Clarity data from January 2013 through September 2023. The US study included nonpregnant adults with T2D who were continuously insured from 1&#xa0;year prior through 5&#xa0;years post diagnosis and did not fill a prescription for an AHA in the year after their initial T2D diagnosis. Differences between those treated in years&#xa0;2–5 with an AHA (delayed treatment) and those untreated with an AHA for 5&#xa0;years post diagnosis (untreated) were examined descriptively and using multivariable analyses.</p> Results <p>Out of 186,259 adults with T2D, 56.7% (<i>N</i> = 105,533) did not fill a prescription for an AHA in the year after diagnosis and were included in the study. Of these 105,533 adults (mean age 59.6&#xa0;years; 51.4% female), 75.0% were untreated for the entire 5&#xa0;years post diagnosis. In the delayed treatment group, metformin was the most common first-line therapy (72.9%), and 83.0% of those who initiated monotherapy never received additional classes of AHAs. Compared to the delayed treatment group, the untreated group had significantly higher rates of incident cardiovascular outcomes and all-cause direct total costs ($118,191 vs $108,687; <i>P</i> &lt; 0.05).</p> Conclusion <p>Over 50% of adults diagnosed with T2D were untreated with an AHA in the first year post diagnosis, and most of those who went untreated the first year remained untreated after 5&#xa0;years. Among the delayed treatment patients, the majority did not use additional AHA classes besides their index therapy in the post-period. These findings suggest that therapeutic inertia affects a significant percentage of individuals with T2D. Given the untreated group’s significantly worse cardiovascular outcomes and higher medical costs, these findings highlight a potential unmet need in the years immediately following T2D diagnosis.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Therapeutic Inertia in an Insured Population with Type 2 Diabetes in the United States: A Retrospective Cohort Study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年9月8日

查看全文
  • Kristina S. Boye,
  • Maureen J. Lage,
  • Kendra A. Terrell,
  • Vivian T. Thieu

摘要

Introduction

This study examines the characteristics of adults with type 2 diabetes (T2D) who were not initially treated with an antihyperglycemic agent (AHA).

Methods

The analyses used Optum de-identified Market Clarity data from January 2013 through September 2023. The US study included nonpregnant adults with T2D who were continuously insured from 1 year prior through 5 years post diagnosis and did not fill a prescription for an AHA in the year after their initial T2D diagnosis. Differences between those treated in years 2–5 with an AHA (delayed treatment) and those untreated with an AHA for 5 years post diagnosis (untreated) were examined descriptively and using multivariable analyses.

Results

Out of 186,259 adults with T2D, 56.7% (N = 105,533) did not fill a prescription for an AHA in the year after diagnosis and were included in the study. Of these 105,533 adults (mean age 59.6 years; 51.4% female), 75.0% were untreated for the entire 5 years post diagnosis. In the delayed treatment group, metformin was the most common first-line therapy (72.9%), and 83.0% of those who initiated monotherapy never received additional classes of AHAs. Compared to the delayed treatment group, the untreated group had significantly higher rates of incident cardiovascular outcomes and all-cause direct total costs ($118,191 vs $108,687; P < 0.05).

Conclusion

Over 50% of adults diagnosed with T2D were untreated with an AHA in the first year post diagnosis, and most of those who went untreated the first year remained untreated after 5 years. Among the delayed treatment patients, the majority did not use additional AHA classes besides their index therapy in the post-period. These findings suggest that therapeutic inertia affects a significant percentage of individuals with T2D. Given the untreated group’s significantly worse cardiovascular outcomes and higher medical costs, these findings highlight a potential unmet need in the years immediately following T2D diagnosis.