Healthcare Resource Utilization in Adults with Type 1 Diabetes Who Have a Prior Type 2 Diabetes Misdiagnosis and Recorded HbA1c in a US Managed Care Population
Author(s)
Diana Brixner, RPh, PhD1, Tariku J. Beyene, PhD2, Malvika Venkataraman, MSc2, Chia-Chen Teng, MSc2, Hung-Yuan P. Chen, MSc2, Hiangkiat Tan, MSc2, Laura R. Wilson, PharmD3, Jessica Dunne, Phd3, Daniel Malone, BS, RPh, PhD1.
1University of Utah, Salt Lake City, UT, USA, 2Carelon Research, Wilmington, DE, USA, 3Sanofi, Morrisstown, NJ, USA.
1University of Utah, Salt Lake City, UT, USA, 2Carelon Research, Wilmington, DE, USA, 3Sanofi, Morrisstown, NJ, USA.
OBJECTIVES: To examine healthcare resource utilization (HCRU) in adults with type 1 diabetes (T1D) with a prior type 2 diabetes (T2D) misdiagnosis.
METHODS: This observational cohort study assessed administrative claims from the Carelon Healthcare Integrated Research Database between Oct 1, 2015, and Dec 31, 2023. Adults (≥18 years) with ≥2 outpatient claims for T1D 30-183 days apart or ≥1 inpatient claim were identified. First T1D diagnosis was the index date. Individuals required ≥12 months continuous medical and pharmacy benefit prior to (baseline) and after index (follow-up). Individuals with ≥2 T2D diagnoses or only 1 T1D diagnosis during 12-month follow-up, or secondary diabetes or pregnancy during 12-month baseline, were excluded. Adults with newly-diagnosed T1D with a prior T2D misdiagnosis during baseline were assessed. In this exploratory analysis, individuals were also required to have ≥1 HbA1c measurement during baseline and ≥3 months post-index. All-cause HCRU was assessed at baseline and follow-up.
RESULTS: Overall, 763 adults had a prior T2D misdiagnosis and a record of HbA1c measures (44% female; mean [SD] age: 50 [14] years; mean [SD] baseline and follow-up duration: 5.0 [3.2] years and 3.6 [1.7] years). During baseline and follow-up, 27% and 24% had inpatient admissions, 44% and 36% had emergency department visits, 100% and 99% had laboratory visits, and 99% and 98% had prescription drug fills. All patients had outpatient visits during both baseline and follow-up.
CONCLUSIONS: In adults with T1D and prior T2D misdiagnosis HCRU appeared to decrease following correct T1D diagnosis. This may suggest that timely and accurate diagnoses might help to prevent unnecessary use of healthcare resources by avoiding inappropriate treatments, reducing redundant tests, and enabling earlier, more effective interventions.
METHODS: This observational cohort study assessed administrative claims from the Carelon Healthcare Integrated Research Database between Oct 1, 2015, and Dec 31, 2023. Adults (≥18 years) with ≥2 outpatient claims for T1D 30-183 days apart or ≥1 inpatient claim were identified. First T1D diagnosis was the index date. Individuals required ≥12 months continuous medical and pharmacy benefit prior to (baseline) and after index (follow-up). Individuals with ≥2 T2D diagnoses or only 1 T1D diagnosis during 12-month follow-up, or secondary diabetes or pregnancy during 12-month baseline, were excluded. Adults with newly-diagnosed T1D with a prior T2D misdiagnosis during baseline were assessed. In this exploratory analysis, individuals were also required to have ≥1 HbA1c measurement during baseline and ≥3 months post-index. All-cause HCRU was assessed at baseline and follow-up.
RESULTS: Overall, 763 adults had a prior T2D misdiagnosis and a record of HbA1c measures (44% female; mean [SD] age: 50 [14] years; mean [SD] baseline and follow-up duration: 5.0 [3.2] years and 3.6 [1.7] years). During baseline and follow-up, 27% and 24% had inpatient admissions, 44% and 36% had emergency department visits, 100% and 99% had laboratory visits, and 99% and 98% had prescription drug fills. All patients had outpatient visits during both baseline and follow-up.
CONCLUSIONS: In adults with T1D and prior T2D misdiagnosis HCRU appeared to decrease following correct T1D diagnosis. This may suggest that timely and accurate diagnoses might help to prevent unnecessary use of healthcare resources by avoiding inappropriate treatments, reducing redundant tests, and enabling earlier, more effective interventions.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
RWD95
Topic
Health Service Delivery & Process of Care, Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)