A presentation by Dr. Andrew Zullo et al. at American Diabetes Associations (ADA) 76th scientific sessions conference revealed a dramatic increase in the incident use of rapid-acting insulin and a modest increase in short-acting insulin between 2008 and 2010 in a national cohort of nursing home (NH) residents.
Data on medication use was assessed using Medicare Part D drug claims. Resident and facility characteristics were assessed prior to medication initiation using Medicare Part A, Minimum Data Set (MDS), and Online Survey, certification and Reporting (OSCAR) database.
N= 11,531 (65 years or older, 90 days or more stay as NH
residents)
|
2008
|
2010
|
% Change
in 12 quarters |
Sulfonylurea
|
25.4%
|
11.7%
|
13.7% ê
|
Metformin
|
12%
|
18.8%
|
6.8% é
|
Dipeptidyl peptidate-4
inhibitors
|
0.9
|
2.7
|
1.8% é
|
Thiazolidinedione
|
4.7
|
1.9
|
2.8% ê
|
Meglitinide
|
1.5%
|
0.3%
|
1.2% ê
|
Insulin
|
51.7%
|
68.3%
|
16.6% é
|
Rapid-acting insulin
|
11%
|
29.4%
|
18.4% é
|
Short-acting
|
22.6%
|
30.3%
|
7.7% é
|
Zullo AR, Dore DD, Daiello L, et al. National Trends in Treatment Initiation for Nursing Home Residents With Diabetes Mellitus, 2008 to 2010. J Am Med Dir Assoc. 2016 Jul 1;17(7):602-8.
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