The purpose of this study was to assess success rates of long-term glycemic control and diabetes drug prescriptions by gender, age and race in a large, state-wide, integrated, electronic health record database in Indiana. Descriptive analysis of a retrospective cohort of 308,4adults with type 2 diabetes observed from 20to 2018 was conducted. The success rate for glycemic control (A1c <7 [<65 y/o] or <8 [>=65 y/o]) was defined as (number of A1c tests meeting target) / (number of A1c tests) in any given year. Sample characteristics included gender, age, race, and diabetes drug prescription rate for twelve classes of diabetes drugs. Analysis of 876,656 year-level observations showed the success rate of glycemic control was steady at 60% with year-to-year change of 0-1% since 2009. It was greater for females (62-64%) than males (57-59%) ; patients aged 65 or above (75-89%) than those below (43-62%) ; and whites (61-63%) than blacks (51-54%) . Biguanides (56-63% = subject n with orders of biguandes in x year/ population n in x year) were most frequently prescribed, followed by sulfonylurea (29-33%) , fast-acting and long-acting insulin (29-32%) . Blacks had more insulin prescription (47-53%) regardless of age group. Costlier drugs were more frequently prescribed among whites vs. non-white: 0.6-1.2% vs. 0.5-0.8 for meglitinides; 10.3-16.7% vs. 1.3-17.3% for DPP-4; 0.5-9.3% vs. 0.2-8.0 for SGLT2i; and 5.3-12.15% vs. 1-11.5% for GLP-1. For blacks who were prescribed insulin (44-53%) , the success rate for glycemic control was lower than for whites (38-43% vs. 46-50%) . The success of longitudinal glycemic control did not improve over a 10-year period among 308,4adults with type 2 diabetes in Indiana. Racial minorities received notably fewer prescriptions for higher-priced drugs such as meglitinide, DPP4, SGLT2, and GLP-1.
H.N.Fu: None. M.Weiner: Stock/Shareholder; AbbVie Inc., Accuray, Inc., Allscripts Healthcare Solutions, Amgen Inc., Boston Scientific Corporation, Bristol-Myers Squibb Company, Crispr Therapeutics Ag Com, Express Scripts Hdlg Co, General Electric Co., Globus Med, Inc., IBM, Integer Hldgs Corp Com, Integra Lifesciences Holdings Corp, Johnson & Johnson, Mallinckrodt PLC, Mead Johnson & Company, LLC., Medtronic, Metlife Inc Com, Mylan N.V., Novo Nordisk A/S, Nuvasive, Inc., Orthofix Medical Inc., Perspecta Inc Com, Pfizer Inc., Resmed, Inc., Roche Pharmaceuticals, Seaspine Hldgs, Inc., Senseonics, Stryker Corp., Teva Pharmaceutical Industries Ltd., Varex Imaging Corp., Varian Med Sys, Inc., Walgreens Boots Alliance, Inc. J.Wolfson: None. T.S.Hannon: Advisory Panel; Eli Lilly and Company. P.Balius: None. T.Schleyer: None.
T15LM012502, UL1TR002529, the Lilly Endowment Physician Scientist Initiative