Table 3 Description of people with diabetes identified through cluster analysis

Cluster Label

Low ER Utilizers with High Comorbid Burden

Endocrinology Utilizers with Concordant Comorbidities

Low ER Utilizers with High Diabetes-related Claims without Discordant Comorbidities

High Inpatient Utilizers with High Comorbid Burden

High ER Utilizers

Endocrinology Utilizers without Concordant Comorbidities

Lowest Overall Utilizers

Number of People (n, %)

22,508 (22.4%)

13,986 (13.9%)

22,880 (22.7%)

5629 (5.6%)

11,351 (11.3%)

10,049 (10.0%)

14,247 (14.2%)

Age (mean, SD) (years)

69.80 (9.85)

65.16 (10.83)

60.71 (10.83)

69.54 (11.98)

64.92 (12.54)

38.34 (12.16)

61.31 (12.51)

Male (%)

48.0%

50.8%

45.4%

48.9%

54.8%

43.0%

49.5%

Household Income (US dollars)¹ Median (Q1 - Q3)

$51,665 ($42,344–$65,516)

$59,733 ($47,149–$77,449)

$51,879 ($42,139–$66,124)

$53,612 ($43,017–$68,301)

$49,154 ($40,163–$61,588)

$65,972 ($51,625–$84,930)

$54,107 ($43,152–$69,429)

Medicare Advantage (%)

80.3%

62.2%

42.6%

81.5%

72.5%

3.8%

51.7%

Diabetes Type T1DM (%)

3.3%

13.6%

2.2%

2.1%

3.6%

69.6%

8.1%

 One or more HbA1c tests performed (%)

66.4%

75.8%

71.3%

54.3%

63.8%

63.0%

15.2%

 Mean (SD)

1.01 (0.91)

1.29 (1.00)

1.02 (0.83)

0.89 (1.21)

1.00 (0.99)

0.87 (0.81)

0.17 (0.41)

 N

7007

6215

7494

1471

3260

3045

2918

 Mean (SD)

8.56 (1.79)

8.60 (1.69)

9.35 (2.07)

8.25 (1.81)

8.95 (2.05)

8.82 (2.02)

8.87 (1.97)

 Pump (%)

2.8%

10.6%

2.1%

4.2%

4.3%

29.2%

1.7%

 BGM (%)

33.3%

38.6%

31.8%

29.6%

35.3%

39.6%

26.2%

 CGM (%)

1.0%

6.8%

0.8%

1.0%

1.2%

14.5%

0.3%

 Basal only

45.0%

27.9%

55.3%

32.5%

40.8%

17.3%

47.4%

 Bolus only

6.2%

15.6%

6.0%

10.9%

8.2%

36.7%

7.2%

 Both

48.7%

56.5%

38.8%

56.6%

51.0%

46.0%

45.3%

Months on Insulin (mean, SD)

4.45 (3.58)

5.02 (3.72)

3.34 (3.15)

2.68 (3.18)

3.70 (3.47)

4.29 (3.25)

3.87 (3.42)

 Number of Concordant Comorbidities (mean, SD)

5.56 (2.17)

4.56 (2.31)

3.29 (1.61)

6.72 (2.34)

5.53 (2.34)

0.52 (0.76)

3.67 (2.19)

 Number of Discordant Comorbidities (mean, SD)

1.40 (1.07)

1.46 (1.26)

0.50 (0.74)

1.44 (1.16)

1.31 (1.14)

0.89 (1.10)

0.88 (0.99)

 Charlson Comorbidity Index (CCI) (mean, SD)

2.70 (1.44)

2.47 (1.50)

1.15 (0.78)

3.92 (2.03)

2.47 (1.61)

1.09 (0.74)

0.30 (0.55)

 Diabetes Complication Severity Index (DCSI) (mean, SD)

1.79 (1.39)

1.33 (1.39)

0.26 (0.58)

3.48 (1.95)

1.66 (1.53)

0.22 (0.56)

0.15 (0.49)

 Median (Q1 - Q3) Number of Medical Claims

11.00 (7.00–18.00)

11.00 (7.00–17.00)

4.00 (2.00–6.00)

43.00 (30.00–64.00)

14.00 (9.00–23.00)

4.00 (2.00–7.00)

3.00 (0.00–6.00)

 Proportion of Medical Claims ^2,3 That are Diabetes Related (mean, SD)

0.46 (0.24)

0.53 (0.24)

0.78 (0.23)

0.53 (0.25)

0.51 (0.24)

0.69 (0.30)

0.19 (0.22)

  All-cause ER visits (%)

0.0%

10.7%

6.2%

45.2%

100.0%

12.0%

6.5%

  All-cause ER visits (mean, SD)

0.00 (0.00)

0.12 (0.36)

0.07 (0.26)

0.82 (1.37)

1.77 (1.50)

0.15 (0.44)

0.07 (0.28)

  All-cause IP visits (%)

11.6%

7.5%

5.4%

99.1%

22.2%

6.0%

3.2%

  All-cause IP visits (mean, SD)

0.13 (0.36)

0.08 (0.31)

0.06 (0.25)

2.11 (1.29)

0.26 (0.53)

0.07 (0.28)

0.03 (0.20)

  All-cause IP days for patients with ≥1 admit (mean, SD)

3.84 (2.04)

3.88 (2.69)

4.07 (2.81)

25.34 (24.57)

4.13 (2.75)

3.61 (2.96)

5.03 (4.14)

  All-cause PCP visits (%)

83.7%

71.4%

79.8%

81.3%

84.1%

55.8%

41.8%

  All-cause PCP visits (mean, SD)

2.60 (2.32)

1.73 (1.88)

1.87 (1.58)

3.44 (3.69)

3.31 (2.97)

1.10 (1.41)

0.86 (1.39)

  All-cause Endocrinologist visits (%)

0.7%

100.0%

4.0%

13.5%

12.1%

39.2%

2.1%

  All-cause Endocrinologist visits (mean, SD)

0.01 (0.08)

1.83 (0.94)

0.04 (0.23)

0.22 (0.69)

0.16 (0.47)

0.58 (0.85)

0.02 (0.15)

  All-cause Cardiologist visits (%)

29.0%

27.5%

5.1%

36.8%

28.8%

2.0%

6.1%

  All-cause Cardiologist visits (mean, SD)

0.46 (0.98)

0.43 (0.90)

0.07 (0.33)

0.79 (1.48)

0.53 (1.13)

0.03 (0.24)

0.08 (0.37)

  No visit to PCP, Endocrinologist or Cardiologist (%)

12.4%

0.0%

17.4%

12.7%

11.2%

21.4%

54.6%

  Diabetes-related ER visits (%)

0.0%

8.5%

5.2%

35.6%

80.8%

9.3%

4.0%

  Diabetes-related IP visits (%)

11.2%

7.3%

5.4%

95.7%

21.3%

5.8%

2.7%

  Diabetes-related IP days for patients with ≥1 admit (mean, SD)

3.81 (2.02)

3.87 (2.67)

4.05 (2.79)

23.64 (22.99)

4.07 (2.71)

3.52 (2.84)

4.88 (4.07)

Cluster Characteristics

• No patients with all-cause or diabetes-related ER visits

• Second highest mean CCI and DCSI scores

• 100% had an Endocrinologist visit

• Highest proportion with 1+ HbA1c tests performed (76%)

• Highest average HbA1c lab value (mean = 9.35)

• Highest proportion of medical claims that were diabetes-related (mean = 0.78)

• Highest proportion of new insulin users (mean = 2.68 months)

• Highest mean CCI and DCSI scores

• Highest average number of medical claims (median = 43)

• Nearly 100% had an Inpatient Hospitalization

• 100% had an ER visit

• 81% had a diabetes-related ER visit

• Higher observed HbA1c (mean = 8.95)

• Highest proportion of type 1 diabetics (70%)

• Youngest (mean age = 38 years)

• Relatively high proportion with an Endocrinology visit (39%)

• Highest diabetes technology use (insulin pump, CGM, and/or BGM)

• Healthiest, according to CCI and DCSI scores

• Largest proportion without PCP, Endocrinologist, or Cardiologist visits (55%)

• Lowest total number of medical claims (median = 3)