A previous study examining Medicare patients with T2DM found that interventions aimed at diabetes have not differed based on comorbid illness burden [18]. Our analysis found that patients with a higher comorbidity burden and more concomitant conditions were significantly Tenatoprazole? more likely to be HC. Therefore, from the perspective of a payer, one practical implication of the present analysis is that it may make sense to provide those patients who have the most comorbidities and concomitant conditions (i.e., those patients who are at the greatest risk of being HC) with additional patient care tailored at treating the comorbidity or concomitant condition (e.g., weight loss programs for obese patients). Sensitivity analyses were conducted, examining the 926,180 patients who received an antidiabetic medication (i.

e., either an oral antidiabetic or insulin). In this subpopulation of treated T2DM patients, those with costs greater than $22,646 comprised the top 10th percentile (vs. $20,528 in the overall T2DM population), while patients with costs greater than $12,349 comprised the top 20th percentile (vs. $10,901 in the overall T2DM population). We found that there were no differences in patient demographics between the overall study sample and those patients who received antidiabetic medication. Predictors of being an HC T2DM patient were the same for the treated and overall T2DM populations. Specifically, in the treated T2DM population, having a CCI score greater than or equal to 2 was the strongest predictor of being an HC patient (OR=4.862; P<0.001), followed by a renal impairment diagnosis (OR=2.

369; P<0.001), an obesity diagnosis (OR=1.991; P<0.001), or receipt of insulin (OR=1.897; P<0.001). Treated patients in the top 10% of the cost distribution accrued approximately $53,917 more in health care costs versus treated patients in the bottom 90% of the cost distribution (vs. $51,794 more in costs in the overall T2DM population), with the largest difference in costs attributable to inpatient stays. Additionally, treated patients in the top 10% of the cost distribution accrued costs of over $5.5 billion, which represented 54.1% of all costs accrued by the treated T2DM population (vs. 57.3% among all T2DM patients). Treated patients in the top 20% of the cost distribution accrued costs of over $7.0 billion, which represented 69.

0% of all costs accrued by the treated T2DM population (vs. 72.3% among all T2DM patients). This study has several limitations common to most retrospective database studies. First, it was not possible to confirm diagnoses for T2DM, renal impairment, hypertension, or obesity. No laboratory Entinostat data were available to further assess the level of renal impairment, and no information was available in the database regarding patients�� height or weight. Thus, rates of obesity and renal impairment reported in the analysis are likely underestimated.