OBJECTIVES: : The impact of type 2 diabetes (T2D) and non-small cell lung cancer (NSCLC) are mutually substantial from a public health perspective. A better understanding of the relationship between T2D and NSCLC would have significant implications for prevention and management of these diseases. The objective of this study is to assess the utilization of diabetic NSCLC patients compared to NSCLC patients.

METHODS: We conducted a cohort study design utilizing Medicare claims from the SEER - Medicare linked database (2007 - 2014). Zero-inflated negative binomial models (ZINB) were used to estimate the average predicted number of visits from the index date in the T2D NSCLC cohort compared to NSCLC patients, stratified by cancer stage. The ZINB adjusted for cancer stage, geographical region, gender, age, race and comorbidities.

RESULTS: Of 17,176 NSCLC patients, 5,096 patients had T2D in the pre-period. The average predicted number of visits per patient per day was higher for the NSCLC T2D patients compared to their non-diabetic peers. Non-Diabetic patients with Stage 1 NSCLC had approximately 0.37 predicted healthcare visits per day, Stage 2 had 0.47, Stage 3 had 0.62 and Stage 4 had 0.76. T2D NSCLC patients with Stage 1 NSCLC had 0.39 predicted healthcare visits per day, Stage 2 had 0.50, Stage 3 had 0.66 and Stage 4 had 0.80.

CONCLUSIONS: The results of this study indicate that NSCLC patients with T2D have greater health care utilization, compared to non-diabetic NSCLC patients. Clinical strategies to better manage NSCLC T2D patients could enhance metabolic health, reduce healthcare utilization and therefore decrease costs.