Appendix
Appendix 1
ICD-9 and CPT codes for clinical outcomes
Cardiovascular-related endpoint (ICD-9 codes)
430-438
Cerebrovascular
disease (Stroke)
410
Acute myocardial
infarction
Cardiovascular death
Coronary artery disease [410-414] or cerebrovascular disease
[430-438] on the day of death
Acute coronary syndromes (ICD-9 codes)
410
Acute myocardial
infarction
411.1
Unstable angina
Microvascular complications (ICD-9 codes)
249.5, 250.5, 362.0, 362.1, 379.23
Retinopathy
249.4, 250.4, 791.0
Nephropathy
249.6, 250.6, 353.5, 356.9, 536.3, 713.5,
Neuropathy
337.1, 357.2, 354, 355
Cardiovascular surgical procedures (ICD-9 procedure codes; CPT codes)
Coronary artery bypass 36.10-36.19; 33510-33536
graft
Percutaneous coronary 00.66, 36.01, 36.02, 36.05, 36.06, 36.07;
92982, 92984, 92980,92981
intervention
Appendix 2
Analysis of Baseline Characteristics Based on Dual-Goal Achievement in the 7-12 Months
Following the Index Date
Dual-goal
Non–dual-goal
(n=7,432)
(n=9,397)
65.5 ± 10.2
61.5 ± 10.6
18-44
160 (2.2)
506 (5.4%)
45-54
798 (10.7)
1,781 (19.0%)
55-64
2,933 (39.5)
4,063 (43.2%)
65-69
992 (13.4)
1,003 (10.7%)
70-74
1,018 (13.7)
869 (9.3%)
Characteristics
P value
Demographics
Age as of the index date, yearsA
Age groups, n (%)
< .001
75-79
874 (11.8)
660 (7.0%)
80+
657 (8.8)
515 (5.5%)
7,243 (97.5)
9,050 (96.3%)
< .001
5,154 (69.4)
6,115 (65.1%)
< .001
31.6 ± 4.9
32. ± 5.4
< .001
Male, n (%)
White, n (%)
Body mass index,
kg/m2B
Index year, n (%)
< .001
2004
1,237 (16.6)
1,579 (16.8)
2005
1,625 (21.9)
2,259 (24.0)
2006
1,230 (16.6)
1,669 (17.8)
2007
1,297 (17.5)
1,535 (16.3)
2008
1,340 (18.0)
1,524 (16.2)
703 (9.5)
831 (8.8)
HbA1c<7%
6,581 (88.6)
5,391 (57.4)
< .001
LDL-C<100 mg/dl
5,982 (80.5)
3,008 (32.0)
< .001
Dual-goal Achievers
3,900 (52.5)
1,380 (14.7)
< .001
Retinopathy
241 (3.2)
517 (5.5)
< .001
Nephropathy
189 (2.5)
230 (2.5)
.693
Neuropathy
799 (10.8)
1,174 (12.5)
< .001
Atherosclerosis, aneurysm, or embolism
230 (3.1)
213 (2.3)
.001
Peripheral vascular disease
417 (5.6)
465 (5.0)
.055
Cerebrovascular disease
595 (8.0)
626 (6.7)
.001
Coronary artery disease
2,448 (32.9)
2,259 (24.0)
< .001
Angina
294 (4.0)
349 (3.7)
.416
Myocardial infarction
60 (0.8)
79 (0.8)
.812
717 (9.7)
901 (9.6)
.897
2,028 (27.3)
2,377 (25.3)
.004
119 (1.6)
134 (1.4)
.354
hyperosmolarity
20 (0.3)
38 (0.4)
.137
Hypoglycemia
197 (2.7)
278 (3.0)
.231
Congestive heart failure
489 (6.6)
539 (5.7)
.023
Valvular heart disease
158 (2.1)
145 (1.5)
.005
7,026 (94.5)
8,781 (93.4)
.003
2009
Baseline goal achievement, n
(%)C
Diabetes-related complications, n (%)
Microvascular
Macrovascular
Other
InfectionD
Ocular
problemsE
UlcerationF
Ketoacidosis (without coma) and
Comorbidities, n (%)
Cardiovascular diseaseG
Hypertension
Other
1,479 (19.9)
1,528 (16.3)
< .001
Obesity
2,086 (28.1)
2,861 (30.5)
.001
Hyperlipidemia
5,500 (74.0)
6,732 (71.6)
.001
Depression
2,713 (36.5)
3,907 (41.6)
< .001
Renal disease
701 (9.4)
730 (7.8)
< .001
Tobacco use
1,329 (17.9)
1,962 (20.9)
< .001
3,610 (48.6)
5,365 (57.1)
< .001
480 (6.5)
1,269 (13.5)
< .001
Anti-hypertensive
5,257 (70.7)
6,514 (69.3)
.047
Lipid lowering
5,539 (74.5)
6,467 (68.8)
< .001
Lower extremity amputation
10 (0.1)
24 (0.3)
.083
Coronary artery bypass graft
28 (0.4)
31 (0.3)
.610
Percutaneous coronary intervention
68 (0.9)
85 (0.9)
.944
Outpatient visit
7,337 (98.7)
9,268 (98.6)
.595
Urgent care visit
1,168 (15.7)
1,669 (17.8)
< .001
903 (12.2)
1,221 (13.0)
.102
400 (5.4)
606 (6.5)
.004
0.3 ± 0.8
0.3 ± 0.7
< .001
CCI = 0, n (%)
5,955 (80.1)
7,882 (83.9)
< .001
1 ≤ CCI <3, n (%)
1,270 (17.1)
1,316 (14.0)
< .001
207 (2.8)
199 (2.1)
.005
Diabetic medications, n (%)
Oral anti-diabetic
Insulin
Surgical Procedures, n (%)
Resource Utilization, n (%)
Inpatient
Emergency room
Charlson comorbidity
CCI ≥ 3, n (%)
indexA
Unless otherwise specified, all characteristics were measured in the 1-year period around the index date (i.e., six months before
and six months after).
AData are means ± SD.
BEstimated using the height and weight information closest to the index date. For patients with no height and weight information,
the average body mass index calculated from all other patients was used.
CCalculated using the area under the curve method for the first six months following the index date.
DIncludes skin, urinary tract, and kidney infections.
EIncludes glaucoma, macular edema, retinal edema, vitreous hemorrhage, and blindness.
F'Includes foot ulcer, bone changes, amputation, and other ulcerations.
GExcludes macrovascular complications.
Statistical significance is indicated with bolded text.
Abbreviations: CCI indicates Charlson comorbidity index; HbA1c, glycosylated hemoglobin A1c; LDL-C, low-density
lipoprotein cholesterol.