Burden of Cardiovascular Disease in Adult Patients with Type 1 Diabetes in the US

BACKGROUND AND OBJECTIVES: The burden imposed by cardiovascular disease (CVD) on patients with type 1 diabetes (T1D) in the US has not been thoroughly addressed. In a retrospective observational analysis of the Optum(®) Clinformatics™ Data Mart database, the prevalence of CVD and cardiovascular risk factors (CVRF) as well as health economic outcomes were evaluated in adults with T1D. METHODS: Patients with at least one T1D medical claim between January 1, 2016, and December 31, 2016, were divided into cohorts based on the presence of CVD and/or CVRF. Descriptive and multivariate analyses enabled comparisons of healthcare resource utilization and costs between the cohorts. RESULTS: The analysis included 12,687 patients: CVD, 2871; CVRF, 5371; and no CVD/CVRF, 4445. The period prevalence of CVD and CVRF in the combined baseline and follow-up periods was 27% and 44%, respectively. Fewer patients in the no-CVD/CVRF cohort had a claim of a diabetes-related inpatient admission compared with the CVD cohort (8% vs. 26%, respectively; P < 0.001, standardized mean difference [SMD] > 0.1). Likewise, fewer patients with no CVD/CVRF visited the emergency department vs. those with CVRF or CVD (diabetes-related: 4% vs. 7% and 18%, respectively; P < 0.001, SMD > 0.1). Higher overall costs were observed for the CVD and CVRF vs. the no-CVD/CVRF cohort ($30,241 and $16,220, respectively, vs. $11,761; P < 0.05 and SMD ≥ 0.1 for both). CONCLUSIONS: Cardiovascular comorbidities are common among US adults with T1D. Considering their significant economic burden, optimal management is of the utmost importance to improve patient outcomes and reduce healthcare costs. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s41669-019-00192-9) contains supplementary material, which is available to authorized users.