Trends and Predictors of Glycemic Control Among Adults With Type 2 Diabetes Covered by Alabama Medicaid, 2011-2019
Despite advances in diabetes management, only one-quarter of people with diabetes in the US achieve optimal targets for glycated hemoglobin A (HbA ), blood pressure, and cholesterol. We sought to evaluate temporal trends and predictors of achieving glycemic control among adults with type 2 diabetes...
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Published in | Preventing chronic disease Vol. 20; p. E81 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Centers for Disease Control and Prevention
14.09.2023
|
Series | Peer Reviewed |
Subjects | |
Online Access | Get full text |
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Summary: | Despite advances in diabetes management, only one-quarter of people with diabetes in the US achieve optimal targets for glycated hemoglobin A
(HbA
), blood pressure, and cholesterol. We sought to evaluate temporal trends and predictors of achieving glycemic control among adults with type 2 diabetes covered by Alabama Medicaid from 2011 through 2019.
We completed a retrospective analysis of Medicaid claims and laboratory data, using person-years as the unit of analysis. Inclusion criteria were being aged 19 to 64 years, having a diabetes diagnosis, being continuously enrolled in Medicaid for a calendar year and preceding 12 months, and having at least 1 HbA
result during the study year. Primary outcomes were HbA
thresholds of <7% and <8%. Primary exposure was study year. We conducted separate multivariable-adjusted logistic regressions to evaluate relationships between study year and HbA
thresholds.
We included 43,997 person-year observations. Mean (SD) age was 51.0 (9.9) years; 69.4% were women; 48.1% were Black, 42.9% White, and 0.4% Hispanic. Overall, 49.1% had an HbA
level of <7% and 64.6% <8%. Later study years and poverty-based eligibility were associated with lower probability of reaching target HbA
levels of <7% or <8%. Sex, race, ethnicity, and geography were not associated with likelihood of reaching HbA
<7% or <8% in any model.
Later study years were associated with lower likelihood of meeting target HbA
levels compared with 2011, after adjusting for covariates. With approximately 35% not meeting an HbA
target of <8%, more work is needed to improve outcomes of low-income adults with type 2 diabetes. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1545-1151 1545-1151 |
DOI: | 10.5888/pcd20.220332 |