Trends in comorbidity burden and treatment patterns in type 2 diabetes: Longitudinal data from a US cohort from 2006 to 2014.

Objective: To gather real-world data on treatment characteristics and comorbidity progression in patients with newly-diagnosed type 2 diabetes (T2D) and evaluate differences by patient age.

Methods: Retrospective analysis of a US administrative claims database including 16,950 subjects with newly-diagnosed T2D in 2006 and a baseline Diabetes Complications Severity Index (DCSI) score of 0. Patients were categorized by DCSI score at year 8 (0, 1-2, or ≥3) and comparatively analyzed based on demographic variables, drug usage, and diabetes-related comorbidities.

Results: Year 8 DCSI score distribution was 0 (29.9%), 1-2 (36.2%), and ≥3 (33.9%). The highest DCSI score subgroup (≥3) was characterized by a significantly greater percentage of males, older age at T2D diagnosis, and higher Medicare enrollment. DCSI progressed most rapidly in the oldest age group (≥65). Among all subjects at year 8, insulin use was significantly highest among subjects with DCSI ≥3 compared with those having a lower DCSI. However, for subjects with DCSI ≥3, insulin use was lower among those in the oldest age group (≥65) relative to younger age groups.

Conclusions: These real-world data suggest a relationship between age at T2D diagnosis and disease progression based on comorbidity burden and lower usage of injectable therapies in older patients.