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LBSUN319 Characteristics And Treatment Patterns Of Hispanic/latino Patients Initiating First Injectable Glp-1ra Or Basal Insulin

Hispanic/Latino (H/L) adults in the United States have greater prevalence of T2D and diabetes-related complications compared to non-Hispanic/Latinos (nH/L). Optimal glycemic control remains a challenge in H/L patients, resulting in poor health outcomes and substantial burden of comorbidities. Inject...

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Autores principales: Hoog, Meredith, Maldonado, Juan M, Halpern, Rachel, Dhangar, Indu, Buysman, Erin, McNiff, Kim, Konig, Manige
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9629366/
http://dx.doi.org/10.1210/jendso/bvac150.607
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author Hoog, Meredith
Maldonado, Juan M
Halpern, Rachel
Dhangar, Indu
Buysman, Erin
McNiff, Kim
Konig, Manige
author_facet Hoog, Meredith
Maldonado, Juan M
Halpern, Rachel
Dhangar, Indu
Buysman, Erin
McNiff, Kim
Konig, Manige
author_sort Hoog, Meredith
collection PubMed
description Hispanic/Latino (H/L) adults in the United States have greater prevalence of T2D and diabetes-related complications compared to non-Hispanic/Latinos (nH/L). Optimal glycemic control remains a challenge in H/L patients, resulting in poor health outcomes and substantial burden of comorbidities. Injectable treatments, such as GLP-1RA and basal insulin, are recommended treatment options for patients with T2D-related complications. However, there is limited information on H/L patients initating these treatments. This retrospective cohort study, conducted using claims data (January 2014−February 2020), described demographics, baseline clinical characteristics and treatment patterns of H/L and nH/L patients with T2D initiating first injectable GLP-1RA or basal insulin. Adult commerical or Medicare Advantage enrollees with ≥1 pharmacy claim for injectable GLP-1RA or basal insulin were included. Index date was the date of first claim for GLP-1RA or basal insulin (January 2015−August 2019); with a 6 months post-index follow-up period. Patients with any injected T2D medications during 12-month baseline period were excluded. Patients were categorized as H/L and nH/L groups from race/ethnicity data. Subsets of patients with ≥2 claims for index GLP-1RAs or ≥3 claims for basal insulin, or with baseline and follow-up A1C values, were analyzed for index medication dose escalation and A1C, respectively. Data were presented descriptively as counts and percentages for categorical variables; means and standard deviations (SD) for continuous variables. The study sample included 9,088 H/L and 52,030 nH/L patients with T2D; 46.8% and 49.5% initiated GLP-1RAs in the H/L and nH/L groups, respectively. Mean (SD) age was 58.3 (13.7) and 61.8 (12.7) years in H/L and nH/L groups, respectively. A majority of H/L (60.6%) and nH/L (52.6%) patients had commercial insurance. The most common comorbidities in H/L and nH/L were hypertension (71.5% and 79.1%), dyslipidemia (68.6% and 71.3%), and obesity (20. 0% and 22.3%), respectively. Mean baseline A1C for H/L and nH/L subset with ≥1 A1C value was 9. 04% and 8.79%, respectively; 14.3% of H/L and 16.8% of nH/L had baseline A1C < 7. 0%. Dose escalation of index medication occured in 37.1% of H/L and 40. 0% of nH/L groups. Patients who discontinued index treatment were 55.4% and 47.3% of H/L and nH/L groups, respectively. Our findings suggest that demographics, comorbidities and treatment patterns varied for H/L and nH/L patients initiating a first injectable treatment. This includes a numerically lower proportion of the H/L group initiating GLP-1RA. Understanding the characteristics of H/L patients may help guide management of T2D in this high-risk population and improve treatment outcomes. Future research on optimizing treatments in H/L patients with T2D could provide additional insight and potentially prevent early manifestation of complications in this group. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.
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spelling pubmed-96293662022-11-04 LBSUN319 Characteristics And Treatment Patterns Of Hispanic/latino Patients Initiating First Injectable Glp-1ra Or Basal Insulin Hoog, Meredith Maldonado, Juan M Halpern, Rachel Dhangar, Indu Buysman, Erin McNiff, Kim Konig, Manige J Endocr Soc Diabetes & Glucose Metabolism Hispanic/Latino (H/L) adults in the United States have greater prevalence of T2D and diabetes-related complications compared to non-Hispanic/Latinos (nH/L). Optimal glycemic control remains a challenge in H/L patients, resulting in poor health outcomes and substantial burden of comorbidities. Injectable treatments, such as GLP-1RA and basal insulin, are recommended treatment options for patients with T2D-related complications. However, there is limited information on H/L patients initating these treatments. This retrospective cohort study, conducted using claims data (January 2014−February 2020), described demographics, baseline clinical characteristics and treatment patterns of H/L and nH/L patients with T2D initiating first injectable GLP-1RA or basal insulin. Adult commerical or Medicare Advantage enrollees with ≥1 pharmacy claim for injectable GLP-1RA or basal insulin were included. Index date was the date of first claim for GLP-1RA or basal insulin (January 2015−August 2019); with a 6 months post-index follow-up period. Patients with any injected T2D medications during 12-month baseline period were excluded. Patients were categorized as H/L and nH/L groups from race/ethnicity data. Subsets of patients with ≥2 claims for index GLP-1RAs or ≥3 claims for basal insulin, or with baseline and follow-up A1C values, were analyzed for index medication dose escalation and A1C, respectively. Data were presented descriptively as counts and percentages for categorical variables; means and standard deviations (SD) for continuous variables. The study sample included 9,088 H/L and 52,030 nH/L patients with T2D; 46.8% and 49.5% initiated GLP-1RAs in the H/L and nH/L groups, respectively. Mean (SD) age was 58.3 (13.7) and 61.8 (12.7) years in H/L and nH/L groups, respectively. A majority of H/L (60.6%) and nH/L (52.6%) patients had commercial insurance. The most common comorbidities in H/L and nH/L were hypertension (71.5% and 79.1%), dyslipidemia (68.6% and 71.3%), and obesity (20. 0% and 22.3%), respectively. Mean baseline A1C for H/L and nH/L subset with ≥1 A1C value was 9. 04% and 8.79%, respectively; 14.3% of H/L and 16.8% of nH/L had baseline A1C < 7. 0%. Dose escalation of index medication occured in 37.1% of H/L and 40. 0% of nH/L groups. Patients who discontinued index treatment were 55.4% and 47.3% of H/L and nH/L groups, respectively. Our findings suggest that demographics, comorbidities and treatment patterns varied for H/L and nH/L patients initiating a first injectable treatment. This includes a numerically lower proportion of the H/L group initiating GLP-1RA. Understanding the characteristics of H/L patients may help guide management of T2D in this high-risk population and improve treatment outcomes. Future research on optimizing treatments in H/L patients with T2D could provide additional insight and potentially prevent early manifestation of complications in this group. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m. Oxford University Press 2022-11-01 /pmc/articles/PMC9629366/ http://dx.doi.org/10.1210/jendso/bvac150.607 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Diabetes & Glucose Metabolism
Hoog, Meredith
Maldonado, Juan M
Halpern, Rachel
Dhangar, Indu
Buysman, Erin
McNiff, Kim
Konig, Manige
LBSUN319 Characteristics And Treatment Patterns Of Hispanic/latino Patients Initiating First Injectable Glp-1ra Or Basal Insulin
title LBSUN319 Characteristics And Treatment Patterns Of Hispanic/latino Patients Initiating First Injectable Glp-1ra Or Basal Insulin
title_full LBSUN319 Characteristics And Treatment Patterns Of Hispanic/latino Patients Initiating First Injectable Glp-1ra Or Basal Insulin
title_fullStr LBSUN319 Characteristics And Treatment Patterns Of Hispanic/latino Patients Initiating First Injectable Glp-1ra Or Basal Insulin
title_full_unstemmed LBSUN319 Characteristics And Treatment Patterns Of Hispanic/latino Patients Initiating First Injectable Glp-1ra Or Basal Insulin
title_short LBSUN319 Characteristics And Treatment Patterns Of Hispanic/latino Patients Initiating First Injectable Glp-1ra Or Basal Insulin
title_sort lbsun319 characteristics and treatment patterns of hispanic/latino patients initiating first injectable glp-1ra or basal insulin
topic Diabetes & Glucose Metabolism
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9629366/
http://dx.doi.org/10.1210/jendso/bvac150.607
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