Insulin Medication Trends in Diabetes Management: A Comprehensive USDDS Database Analysis

Abstract

Background: Insulin medication trends in diabetes management have evolved significantly over the past two decades, influenced by demographic factors and advancements in treatment. Analyzing these trends from 2000 to 2022 helps identify disparities and informs strategies for optimizing diabetes care across diverse populations. Methods: This retrospective, observational study analyzed United States Diabetes Data System (USDDS) data from 2000 to 2022. Adult diabetic patients were categorized by age, gender, race, and education. Insulin-only usage percentages were calculated annually, with statistical analyses conducted to identify trends and disparities across demographics. Data confidentiality was maintained, using de-identified information to ensure compliance with ethical standards. Results: The analysis of insulin medication trends from 2000 to 2022 reveals significant changes in diabetes management. The analysis shows that the proportion of patients using pills only increased from 45.6% in 2000 to a peak of 52.7% in 2011, then slightly decreased to 49.5% in 2022.  The proportion of patients using both insulin and pills increased from 11.2% in 2000, reached a peak of 16.8% in 2019, and then stabilized at 16.3% in 2022.  Insulin-only usage decreased from 25.6% to around 17-18%, indicating a shift towards combination therapies. Age-specific trends show a decline in insulin-only use among older adults and variability among younger adults. Gender-specific trends reveal an initial decline in insulin-only use, with males generally showing higher percentages in later years. Race and education-specific trends indicate varying patterns, with higher insulin-only usage among Non-Hispanic Whites and those with higher education. These trends highlight evolving diabetes management practices influenced by advancements and socio-economic factors. Conclusion: The 22-year analysis of insulin medication trends highlights a shift towards increased use of oral medications and combination therapies in diabetes management. Significant variations in insulin-only usage were observed across different demographics, including age, gender, race, and education level, reflecting evolving clinical practices, advancements in treatment options, and socio-economic influences on diabetes care.