EVALUATING THE ROLE OF HYPOGLYCEMIA & COMORBID ILLNESS ON DIABETES MANAGEMENT BEHAVIORS

摘要: Over the recent years, incidence of diabetes has significantly increased. Use preventive services and treatment with oral antidiabetic drugs (OAD) remained cornerstone in management type 2 (T2DM). Despite strong evidence that treating using these disease strategies decreases morbidity, mortality complications, glycemic control as well other related outcomes remain unsatisfactory. The prevalence United States grown vastly proportion over last few years American Diabets Association estimating 9.3% population suffered from year 2012. These estimates are expected to increase future World Health Organization (WHO) 366 billion people (4.4%) will have diabetes. Diabetes places a greater clinical economic burden on patients health care system. presence comorbid depression is frequent suffering can cause Poor adherence persistence diabetic medications resulting occurrence adverse events poor outcomes. There continuing need evaluate associations between comorbidities common complications medication persons examine how they influence behavior. Evidence regarding differences utilization without scant. Similarly, factors predispose an individual hypoglycemia association hypoglycemic episodes OAD therapy, specifically sulfonylureas, rarely been quantified retrospectively. This dissertation utilizes manuscript format four fold objectives: 1. To review current literature role their impact aspects management; 2. quantify effect rates service use nationally representative US adults; 3. identify significant predictors estimate costs associated inpatient outpatient settings. 4. development sulfonylurea therapy newly initiated this class medications. In order diabetes, we utilized various biomedical psychological databases. We analyzed principal risk factor ADA recommended Medical Expenditure Panels Survey Data. A logistic regression was performed achieve objective all relevant confounders were controlled for results. Claims data provided by Blue Cross Shield Rhode Island assess relationship outline hypoglycemia. time-varying Cox proportional hazards model compare hazard rate discontinuation exposed events, compared those unexposed. predictive modelling approach highlight While both clinically economically, it seen extent comparable but suboptimal general thus indicating major gaps implementation practices. not increased services, sociodemographic contribute. Moreover, though no subsequent illustrated, demonstrated several profound developing episodes.