OBJECTIVE Hypoglycemia is a cause of significant morbidity among patients with diabetes and may be associated greater risk death. We conducted retrospective study to determine whether patient self-report severe hypoglycemia increased mortality. RESEARCH DESIGN AND METHODS Adult (N = 1,020) seen in specialty clinic between August 2005 July 2006 were questioned about frequency during preencounter interview; 7 lost follow-up excluded from analysis. Mild was defined as symptoms managed without...

The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing. health care burden resulting from the multidisciplinary management this complex unknown. We assessed total cost and resource utilization associated with a new NAFLD diagnosis, compared controls similar comorbidities. used OptumLabs Data Warehouse, large national administrative claims database longitudinal data over 100 million individuals enrolled in private Medicare Advantage plans. identified 152,064 adults first...

<h3>Importance</h3> Severe hypoglycemia is a serious and potentially preventable complication of diabetes, with some the most severe episodes requiring emergency department (ED) care or hospitalization. A variety health conditions increase risk hypoglycemia. People diabetes often have multiple comorbidities, association such multimorbidity in context other factors uncertain. <h3>Objective</h3> To examine associations age, cumulative multimorbidity, glycated hemoglobin (HbA_1c)...

Food is the leading cause of anaphylaxis in children seen emergency departments United States, yet data on department visits and hospitalizations related to food-induced are limited. The objective our study was examine national time trends pediatric anaphylaxis-related hospitalizations.We conducted an observational using a administrative claims database from 2005 through 2014. Participants were younger than 18 years with visit or hospitalization for anaphylaxis. Outcome measures included...

<h3>Importance</h3> Glucagonlike peptide-1 receptor agonists (GLP-1RA), sodium-glucose cotransporter-2 inhibitors (SGLT2i), and dipeptidyl peptidase-4 (DPP-4i) are associated with low rates of hypoglycemia, postmarketing trials GLP-1RA SGLT2i demonstrated that these medications improved cardiovascular kidney outcomes. <h3>Objective</h3> To compare trends in initiation treatment GLP-1RA, SGLT2i, DPP-4i by older adults type 2 diabetes insured Medicare Advantage vs commercial health plans....

Insulin analogs are molecularly altered forms of insulin.Compared with human synthetic and animal insulin for treatment type 2 diabetes, short-acting may offer flexible dosing convenience, long-acting less nocturnal hypoglycemia, 1 but both at greater cost. Because have become increasingly popular, 3,4 we examined trends in use, out-of-pocket expenditures, severe hypoglycemic events among privately insured US adults diabetes from 2000 through 2010.

Children with psoriasis are at increased risk for comorbidities. Many children also overweight or obese; it is unknown whether the of comorbidities in these independent obesity.To determine elevated lipid levels (hyperlipidemia/hypertriglyceridemia), hypertension, metabolic syndrome, polycystic ovarian diabetes, nonalcoholic liver disease, and enzyme without psoriasis, after accounting obesity.This was a retrospective cohort study claims data from Optum Laboratories Data Warehouse (includes...

The authors compared long-term health care use and cost in women undergoing immediate autologous breast reconstruction implant-based reconstruction.This study was conducted using the OptumLabs Data Warehouse, which contains deidentified retrospective administrative claims data, including medical eligibility information from a large U.S. insurance plan. Women who underwent or between January of 2004 December 2014 were included. 2-year rates predicted costs care. Comparisons tested t...

OBJECTIVE To examine whether glucagon-like peptide 1 receptor agonists (GLP-1RA) and sodium–glucose cotransporter 2 inhibitors (SGLT2i) are preferentially initiated among patients with cardiovascular disease, heart failure (HF), or nephropathy, where these drug classes have established benefit, compared dipeptidyl peptidase 4 (DPP-4i), for which corresponding benefits not been demonstrated. RESEARCH DESIGN AND METHODS We retrospectively analyzed claims of adults type diabetes included in...

Hyperglycemic crises (ie, diabetic ketoacidosis [DKA] and hyperglycemic hyperosmolar state [HHS]) are life-threatening acute complications of diabetes. Efforts to prevent these events at the population level have been hindered by scarce granular data difficulty in identifying individuals highest risk.To assess sociodemographic, clinical, treatment-related factors associated with adults type 1 or 2 diabetes US from 2014 2020.This retrospective cohort study analyzed administrative claims...

Background EAST‐AFNET 4 (Early Treatment of Atrial Fibrillation for Stroke Prevention Trial) demonstrated clinical benefit early rhythm‐control therapy (ERC) in patients with new‐onset atrial fibrillation (AF) and concomitant cardiovascular conditions compared current guideline‐based practice. This study aimed to evaluate the generalizability routine Methods Results Using a US administrative database, we identified 109 739 newly diagnosed AF during enrollment period 4. Patients were...

Background Sepsis is associated with an elevated risk of late cardiovascular events among hospital survivors. Methods and Results We included OptumLabs Data Warehouse patients from 2009 to 2019 who survived a medical/nonsurgical hospitalization lasting at least 2 nights. The association between sepsis during hospitalization, based on explicit implicit discharge International Classification Diseases, Ninth Revision ( ICD‐9 )/ Tenth ICD‐10 ) diagnosis codes, subsequent death rehospitalization...

A recent subanalysis of the EAST-AFNET 4 (Early Treatment Atrial Fibrillation for Stroke Prevention Trial) suggests a stronger benefit early rhythm control (ERC) in patients with atrial fibrillation and high comorbidity burden when compared to lower burden.

Background The 2009 US Preventive Services Task Force breast cancer screening update recommended against routine mammography for women aged 40–49; confusion and release of conflicting guidelines followed. We examined the impact USPSTF on population-level rates in ages 40–49. Methods Findings conducted a retrospective, interrupted time-series analysis using nationally representative, privately-insured population from 1/1/2006-12/31/2011. Women 40–64 enrolled ≥1 month were included. primary...

What is the extent and effect of excessive testing for glycated hemoglobin (HbA1c) among adults with controlled type 2 diabetes?A retrospective analysis data from a national administrative claims database included commercially insured individuals in USA, 2001-13. Study patients were aged 18 years or older, had diabetes stable glycemic control (two consecutive tests showing HbA1c<7.0% within 24 months), did not use insulin, no history severe hypoglycemia hyperglycemia, pregnant. HbA1c...

Introduction Glycemic targets and glucose-lowering regimens should be individualized based on multiple factors, including the presence of comorbidities. We examined contemporary patterns glycemic control use medications known to cause hypoglycemia among adults with diabetes across age multimorbidity. Research design methods retrospectively glycosylated hemoglobin (HbA 1c ) levels rates insulin/sulfonylurea as a function multimorbidity using administrative claims laboratory data for type 2...

Drugs are most typically defined as specialty because they expensive; however, other criteria used to define a drug include biologic drugs, the need inject or infuse drug, requirement for special handling, availability only via limited distribution network. Specialty drugs play an increasingly important role in treatment of chronic conditions such multiple sclerosis (MS), rheumatoid arthritis (RA), psoriasis, and inflammatory bowel disease (IBD), yet little is known regarding comprehensive...