A groundbreaking study conducted by the Texas A&M University School of Public Health has shed new light on the factors that contribute to the rising costs faced by patients with type 2 diabetes. The study, published in BMC Health Services Research, found that high A1C values, diabetes complications, and other comorbidities are key drivers of increased overall costs for type 2 diabetes patients, particularly those living in rural areas.
In the United States, the prevalence of diabetes has more than doubled over the past two decades, largely due to a rise in obesity and an aging population. Currently, over 37 million Americans have diabetes, with more than 90% diagnosed with type 2 diabetes (T2D). In Texas alone, 2.7 million residents, or 12.9% of the population, were living with diabetes in 2019. The annual cost of diabetes and prediabetes in Texas has been estimated at a staggering $25.6 billion.
The study was part of the Texas A&M Rural Moonshot Initiative, sponsored by Blue Cross and Blue Shield of Texas (BCBSTX). The research team, led by Dr. Gang Han and Dr. Marcia Ory, used innovative statistical analysis software to gain a deeper understanding of the cost trajectories associated with diabetes in Texas.
By analyzing data from Texas insurance claims issued by a large commercial insurer between 2016 and 2019, the researchers were able to identify different groups of Texans with diabetes based on their cost trajectories. This unique approach allowed them to consider factors such as A1C levels—a blood test that measures average blood sugar levels over a three-month period for diagnosis and treatment—in their analysis.
Dr. Han highlighted the potential flaw in previous studies that failed to account for the diverse characteristics of patients with diabetes. He explained that while some patients may experience increased costs over time at any given A1C level, others may exhibit stable costs at both low and high levels. Additionally, other variables in the dataset can introduce noise that hinders the identification of clinically significant factors.
The findings from this study provide invaluable insights into the cost patterns for patients with type 2 diabetes in Texas. Understanding these patterns is crucial for healthcare professionals and policymakers in managing and preventing diabetes. Dr. Ory emphasized the importance of this research for improving the management of diabetes and potentially reducing its prevalence.
The utilization of group-based trajectory modeling, a statistical technique that classifies different patterns of change over time, allowed the researchers to analyze projected costs. The study team utilized the Proc Traj procedure within the statistical analysis software SAS to identify and analyze clusters of patients based on their cost changes over time. This novel approach provided new and valuable insights into the cost patterns for patients with type 2 diabetes.
With diabetes imposing a growing burden on healthcare systems and individuals worldwide, studies like this are crucial for developing effective strategies to manage and mitigate the costs associated with the disease. By uncovering the factors that drive up costs for type 2 diabetes patients, healthcare professionals and policymakers can work towards implementing targeted interventions and initiatives to improve patient outcomes and reduce the economic impact of the disease.