Presentation (CTI)

OBJECTIVES: This real-world evidence study aimed to investigate the modifiable factors influencing the risk of hospitalization in patients with Type 2 Diabetes (T2D).
METHODS: Using longitudinal administrative data from the Lithuanian National Health Insurance Fund (NHIF) Sveidra database, we analyzed 208,766 observations from 104,383 T2D patients over a 2-year follow-up period. A Generalized Estimating Equations (GEE) model was employed to assess the impact of key lagged predictors, including HbA1c control, metformin adherence (measured as Proportion of Days Covered - PDC), healthcare utilization, demographics, and comorbidity, on hospitalization risk. Two primary outcomes were considered: Outcome A (hospitalization with diabetes as the primary diagnosis) and Outcome B (hospitalization with diabetes as either the primary or secondary diagnosis).
RESULTS: Optimal glycemic control was found to significantly reduce the odds of hospitalization for Outcome A by 78% and for Outcome B by 52%. High metformin adherence, treated as a continuous variable (PDC), reduced the odds of hospitalization for Outcome A by 56.1% per unit increase in PDC and for Outcome B by 39.5% per unit increase. Conversely, increased comorbidity, female sex, and older age were associated with a higher risk of hospitalization. Frequent General Practitioner (GP) visits demonstrated a protective effect specifically for Outcome B.
CONCLUSIONS: This study provides compelling real-world evidence that optimal glycemic control and high metformin adherence are crucial, modifiable factors that significantly reduce T2D-related hospitalizations.