Diabetes care · 2026
Gaps in Diagnosis and Treatment of Patients With Laboratory-Confirmed Diabetes: A National Cohort Study.
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Stimpson Jim P, Tang Yixin, Pena Bojorges Robin, Liao Joshua M
Аннотация
OBJECTIVE: To characterize gaps in diagnostic coding and pharmacologic treatment among adults with laboratory-confirmed diabetes.
RESEARCH DESIGN AND METHODS: We conducted a retrospective cohort study using national commercial and Medicare claims (2017-2023) linked to laboratory results. Adults with laboratory-confirmed diabetes and no prior diabetes/prediabetes were observed for 1 year. Outcomes were type 2 diabetes diagnostic coding and pharmacologic treatment initiation.
RESULTS: Among 27,650 adults with laboratory-confirmed diabetes, 66.6% received both a diagnosis code and pharmacologic treatment within 1 year; 19.7% received a diagnosis only, 4.1% received treatment only, and 9.6% received neither. Compared with HbA1c 6.5-6.9%, higher HbA1c was associated with progressively higher probabilities of diagnostic coding and treatment initiation, whereas greater comorbidity burden was associated with lower probabilities of both outcomes.
CONCLUSIONS: One-third of adults with laboratory-confirmed diabetes lacked claims-documented diagnostic coding, treatment, or both, with patterns of care defined by glycemic severity and comorbidity burden.
RESEARCH DESIGN AND METHODS: We conducted a retrospective cohort study using national commercial and Medicare claims (2017-2023) linked to laboratory results. Adults with laboratory-confirmed diabetes and no prior diabetes/prediabetes were observed for 1 year. Outcomes were type 2 diabetes diagnostic coding and pharmacologic treatment initiation.
RESULTS: Among 27,650 adults with laboratory-confirmed diabetes, 66.6% received both a diagnosis code and pharmacologic treatment within 1 year; 19.7% received a diagnosis only, 4.1% received treatment only, and 9.6% received neither. Compared with HbA1c 6.5-6.9%, higher HbA1c was associated with progressively higher probabilities of diagnostic coding and treatment initiation, whereas greater comorbidity burden was associated with lower probabilities of both outcomes.
CONCLUSIONS: One-third of adults with laboratory-confirmed diabetes lacked claims-documented diagnostic coding, treatment, or both, with patterns of care defined by glycemic severity and comorbidity burden.