Trends and Determinants of Oral Anti-Diabetic Initiation in Youth with Suspected Type 2 Diabetes |
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Authors: | Mona Cai Michael D. Kappelman Cynthia J. Girman Nina Jain Til Stürmer Maurice Alan Brookhart |
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Affiliation: | 1. Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, United States of America.; 2. Department of Pediatrics, Division of Pediatric Gastroenterology, UNC School of Medicine, Chapel Hill, NC, United States of America.; 3. CERobs Consulting, LLC, Chapel Hill, NC, United States of America.; 4. Department of Pediatrics, Division of Pediatric Endocrinology, UNC School of Medicine, Chapel Hill, NC, United States of America.; McMaster University, CANADA, |
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Abstract: | ObjectiveTo evaluate trends and identify predictors of treatment initiation of oral anti-diabetic drugs (OAD) in youth.Patients and MethodsWe identified a select population of children, ages 8–18 years, with at least 13 months of continuous health plan coverage within the years 2001–2012 in a large US commercial insurance claims database. New use of an OAD was defined as the first claim for an outpatient dispensing following a 12-month wash out period. Treatment incidence was estimated monthly over the study period, and stratified by age, gender, geographic region, and provider specialty.ResultsThe median size of the source population during the study period was 2.2 million children. A total of 13,824 initiators (mean monthly incidence of 4.6 (95% CI = 3.6, 5.5) per 100,000 youths) were identified. Initiators were more likely to be females, age 15–18, from the southern region, and have visited a family practitioner (versus a general pediatrician) prior to initiation. Time trends demonstrate a 43% increase in initiation from 2002–2012, with a gradual decrease starting from early 2008.ConclusionIncidence of filled OAD medications in youth increased over time, especially for patients treated by family practitioners. Additional research is needed into factors influencing prescribing by family practitioners and pediatricians. |
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