Appendices
Appendix 1 – Baseline Characteristics
Covariate
Age
Sex
Race
Baseline year
Total N distinct oral anti-diabetic agents
prescribed in past 180 days
Comorbidity score, Charlson
N distinct generics
N physician visits
Hospitalization (Y/N)
Visit to endocrinologist (if we have specialty)
Depression
Renal impairment
Hypertension
Hypercholesterolemia
Congestive heart failure
Coronary atherosclerosis
Cardiac dysrhythmia
Stroke and/or transient ischemic attack
Peripheral vascular disease
Ischemic heart disease
Definition*
293.83, 296.2x, 296.3x, 296.90,
298.0x, 300.4x, 309.0x, 309.1x,
309.28, 311
585.x
401.xx-405.xx
272.0, 272.4, 272.9
Inpatient hospitalization with 428.xx as
the primary diagnosis
414.0x
427.xx, exclude 427.5
Inpatient hospitalization with diagnosis
in any position of: 430.x, 431.x,
433.x1,
434.x (exclude 434.x0), 436.x
Transient ischemic attack: 435.x
433.9, 433.90, and 433.91, 433.30,
433.31, 433.8, 433.80, 433.81
Any of the following drugs,
procedures, or diagnoses
MI: ICD-9 dx: 410, 412, DRG: 121,
122, 123
PTCA (CPT-4: 92982, 92995, 92997,
92982-92984, ICD-9 proc: 00.66,
36.03, 36.09, DRG: 112, 555)
Stent (CPT-4: 92980, 92981, ICD-9:
36.06, 36.07, DRG: 556, 557,558)
CABG surgery (CPT-4: 33510 –
33545, ICD-9: 36.1x, 36.2x, DRG:
106, 107, 109, 547, 548, 549, 550)
Hyperglycemia
Diabetic ketoacidosis
Hyperosmolar hyperglycemic nonketotic
syndrome (HONK)
Diabetes with coma
Hypoglycemic coma
Hypoglycemia
Diabetic retinopathy
Macular edema
Diabetic nephropathy
Pyelonephritis/infections of kidney
End-stage renal disease
Diabetic neuropathy
Amputation
Angina: 411.x, 413.x
nitroglycerin prescription
790.29
250.1x
250.2x
250.3x, excluding 250.30
251.0, 250.30
251.1, 251.20, 962.30, 775.60
Also, 250.8x as long as none of the
following codes are co-diagnoses:
259.8, 272.7, 681.xx, 682.xx, 686.9x,
707.xx, 709.3, 730.0-730.2, 731.8
362.01-362.07
362.8
583.81
590.xx
ICD-9 diagnosis: 585.6
250.6, 357.2
ICD-9 diagnosis: V49.7x – lower limb
amputation status, V52.1 – artificial
leg
ICD-9 procedure: 84.1x
CPT: 26910, 27290, 27295, 27590 –
27598, 27803, 27880-27889, 28800,
28804, 28805, 28810, 28820, 28825
Gastroparesis
536.3
Diabetic foot
707.1x (ulcer of lower limbs)
Osteoporosis
733.0x
Hypertensive chronic kidney disease
403.xx – 404.xx
Chronic kidney disease
585.xx
Skin infections
680.xx-686.xx
Skin ulcer
682.xx
Erectile dysfunction
607.84
Urinary tract infection
599.0
Atherosclerosis of extremity with ulceration
440.23
*unless otherwise noted, clinical conditions are defined based on the presence of an
inpatient or outpatient diagnosis in any position
Appendix 2 – Diabetes Medications
Oral anti-diabetic agents
Biguanides
metformin
Alpha-glucosidase inhibitors
acarbose
miglitol
Thiazolidinediones
pioglitazone
rosiglitazone
Meglitinides
nateglinide
repaglinide
Sulfonylureas
chlorpropamide
tolazamide
tolbutamide
glipizide
gliclazide
glimepiride
glyburide
Dipeptidyl peptidase-4 inhibitors
saxagliptin
sitagliptin
linagliptin
Non-insulin injected agents
Glucagon-like peptide 1 (GLP-1) analog
exenatide
liraglutide
Amylin analog
pramlintide
Basal insulin
insulin human isophane (NPH)
insulin human zinc
insulin human zinc, extended
insulin detemir
insulin glargine, recombinant
Insulin mixtures
insulin human isophane (NPH)/insulin human regular
insulin lispro/insulin lispro protamine
insulin aspart/insulin aspart protamine
Mealtime Insulin
insulin aspart, recombinant
insulin glulisine
insulin lispro, recombinant
insulin human regular
insulin human regular, buffered
Appendix 3– Treatment intensification patterns following a 30 day insulin initiation phase.
Insulin Regimen
During Initiation
Phase
Basal only
Mixed only
Basal + mealtime
Total
N
3,641
897
1,051
5,589
Changes in medication use during intensification phase
Increase in insulin dose / frequency
Additions to treatment Discontinue
regimen
insulin
Basal
Mixed
Mealtime
Mealtime
Mixed
insulin
insulin
910 (25.0)
--377 (10.4)
96 (2.6)
938 (25.8)
-226 (25.2)
---238 (26.5)
211 (20.1)
-211 (20.1)
--296 (28.2)
-----1,472 (26.3)