Diabetes is an epidemic affecting more than 37 million individuals in the United States. Approximately 90 to 95% of these individuals have type 2 diabetes, which means their body cannot properly control the amount of glucose in their blood. This chronic disease has the potential for a wide range of complications — including death and disability from heart attack, stroke and kidney failure, as well as blindness and amputations from damage to nerve and blood vessels.
Management of type 2 diabetes can be difficult. Many individuals need to be prescribed antidiabetic medication as a first line of treatment to help lower blood sugar levels.
Diabetes does not affect all people equally. Early research has indicated that individuals who had Covid-19 are at higher risk, and there has long been a higher prevalence of the disease among some racial and ethnic groups than others. In addition, diabetes is typically more common in communities with lower employment and wealth, and less access to healthy food, higher education and health care. These disparities in social determinants of health make preventing and managing type 2 diabetes more challenging.
This analysis was a retrospective, cohort study examining integrated pharmacy and medical data from January 1, 2018 to December 31, 2020 for approximately 4 million commercially insured customers whose pharmacy benefits were managed by Express Scripts, Inc. Patients diagnosed with type 2 diabetes mellitus (T2DM) aged 18 to 63 who filled at least two 30-day adjusted prescription medications for oral antidiabetic agents (non-injectable and non-insulin medications) between January 1, 2019 and December 31, 2019 were included in the analysis. Their diagnosis was within 365 days prior to the first oral antidiabetic drug claim. Adherence to oral antidiabetic medications was the proportion of patients with percent of days covered (PDC) >80% during their measurement period. Emergency department visits were identified as “diabetes-related” with a primary diagnosis of T2DM; “all cause” visits have a secondary diagnosis of T2DM.