Predictors of insulin pump initiation among people with type 2 diabetes from a US claims database using machine learning.

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  • Additional Information
    • Source:
      Publisher: Informa Healthcare Country of Publication: England NLM ID: 0351014 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1473-4877 (Electronic) Linking ISSN: 03007995 NLM ISO Abbreviation: Curr Med Res Opin Subsets: MEDLINE
    • Publication Information:
      Publication: 1995- : Newbury, Berkshire, U.K. : Informa Healthcare
      Original Publication: London, M. D. Promotions, ltd.
    • Subject Terms:
      Diabetes Mellitus, Type 2*/drug therapy ; Diabetes Mellitus, Type 2*/epidemiology; Adult ; Humans ; United States/epidemiology ; Hypoglycemic Agents/therapeutic use ; Retrospective Studies ; Case-Control Studies ; Blood Glucose Self-Monitoring ; Insulin/therapeutic use ; Blood Glucose/metabolism ; Machine Learning
    • Abstract:
      Objective: Insulin pump use is increasing among people with type 2 diabetes (T2D), albeit at a slower rate compared to people with type 1 diabetes (T1D). Factors associated with insulin pump initiation among people with T2D in the real-world are understudied.
      Methods: This retrospective, nested case-control study aimed to identify predictors of insulin pump initiation among people with T2D in the United States (US). Adults with T2D who were new to bolus insulin use were identified from the IBM MarketScan Commercial database (2015-2020). Candidate variables of pump initiation were entered into conditional logistic regression (CLR) and penalized CLR models.
      Results: Of the 32,104 eligible adults with T2D, 726 insulin pump initiators were identified and matched to 2,904 non-pump initiators using incidence density sampling. Consistent predictors of insulin pump initiation across the base case, sensitivity, and post hoc analyses included continuous glucose monitor (CGM) use, visiting an endocrinologist, acute metabolic complications, higher count of HbA1c tests, lower age, and fewer diabetes-related medication classes.
      Conclusions: Many of these predictors could represent a clinical indication for treatment intensification, greater patient engagement in diabetes management, or proactive management by healthcare providers. Improved understanding of predictors for pump initiation may lead to more targeted efforts to improve access and acceptance of insulin pumps among persons with T2D.
    • Contributed Indexing:
      Keywords: real-world; Insulin pump; bolus insulin; type 2 diabetes
    • Accession Number:
      0 (Hypoglycemic Agents)
      0 (Insulin)
      0 (Blood Glucose)
    • Publication Date:
      Date Created: 20230504 Date Completed: 20230612 Latest Revision: 20231124
    • Publication Date:
      20231124
    • Accession Number:
      10.1080/03007995.2023.2205795
    • Accession Number:
      37139823