Medical expenditure trajectory and HbA1c progression prior to and after clinical diagnosis of type 2 diabetes in a commercially insured population in the USA
Authors' conclusion
Medical expenditures and HbA1c values followed similar trajectories before and after diabetes diagnosis. Our results can inform economic evaluations of programs and policies aimed at preventing type 2 diabetes.
Study context
- Population
- Commercially insured individuals with T2D in the USA, up to 10 years before and 2 years after diagnosis; insurance claims and laboratory test results
- Participants
- 9,847 participants83,526 person-years
- Exposure
- Years before and after T2D diagnosis vs index year
- Outcome
- Annual total medical expenditures and average HbA1c values by years from diagnosis
- Follow-up
- Up to 10 years before and 2 years after diagnosis
Methodological detailsthree longitudinal cohorts (2014, 2015, 2016), individual fixed regression models, risk-adjusted
- Three longitudinal cohorts (2014, 2015, 2016)
- Individual fixed regression models
- Risk-adjusted
Main finding
As reported in the abstract
- Medical expenditures lower 10 years before diagnosis vs index year
- $8644
- Medical expenditures lower 1 year before diagnosis vs index year
- $5781
- HbA1c lower 10 years before diagnosis vs index year
- 12.18 mmol/mol (1.11 percentage points)
- HbA1c lower 1 year before diagnosis vs index year
- 3.49 mmol/mol (0.32 percentage points)
- Average annual increase in medical expenditures over prediagnosis period
- $318
- Average annual increase in HbA1c over prediagnosis period
- 0.97 mmol/mol (0.09 percentage points)
Observational data: associations, not effects.
Original publication
Medical expenditure trajectory and HbA1c progression prior to and after clinical diagnosis of type 2 diabetes in a commercially insured population in the USA. BMJ Open Diabetes Res Care. Published 1 November 2023. doi:10.
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