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Treatment Trends for Youth-Onset Type 2 Diabetes Mellitus in the United States

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2020, MS, University of Cincinnati, Pharmacy: Pharmaceutical Sciences.
Background: Type 2 diabetes mellitus (T2DM) is a chronic, progressive disease characterized by insulin resistance, glucose intolerance, and hyperglycemia. Over the years, the prevalence of T2DM has increased in children and adolescents, and it's associated with a rapid decline in beta-cell function and complications. There is limited literature that examines treatment trends and racial disparities in youths with T2DM. Goal and aims: The aim of this study is to describe the patient characteristics of youth-onset T2DM; to determine pharmacological and non-pharmacological treatment trends in the management of youth-onset T2DM and to examine the disparities in the treatment of youth-onset T2DM among different racial and ethnic groups. Methods: This was a retrospective cross-sectional study that analyzed the National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) from 2006-2017. Patient visits with T2DM were identified using the International Classification (ICD) code and the binary question in the NAMCS/NHAMCS survey, “Does patient now have Diabetes mellitus Type 2”. Descriptive statistics, chi-squared tests, and weighted logistic regressions were carried out to assess treatment patterns and disparities in treatment among different racial and ethnic groups. Results: Patient visits were mostly between the ages of 15-19 years (62.6%) and female patients represented more than half of the study population (59.8%). The majority of the visits were non-Hispanics (83.9%), white (64.3%) and from the southern region of the United States (48.8%). The percentage of patient visits that received an antidiabetic drug decreased from 79.9% in 2006-2011 to 46.5% in 2012-2017 (P=0.0007), and the percentage of patients who did not receive treatment increased from 12.6% to 41.3% in the same time period (P=0.0002). For patient visits with non-pharmacological intervention, the percentage decreased from 38.5% in 2006-2011 to 33.1% in 2012-2017 (P=0.6917). Racial disparities were observed, non-Hispanic blacks were more likely to receive a lifestyle intervention when compared to other racial/ethnic groups(P=0.024), and whites were more likely to receive only an antidiabetic without lifestyle interventions when compared to other races(P=0.045). Conclusion:
Ana Hincapie, Ph.D. (Committee Chair)
Pamela Heaton, Ph.D. (Committee Member)
Nicholas Messinger, Pharm.D. (Committee Member)
76 p.

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Citations

  • Damachi, U. T. (2020). Treatment Trends for Youth-Onset Type 2 Diabetes Mellitus in the United States [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1592171636938994

    APA Style (7th edition)

  • Damachi, Udim. Treatment Trends for Youth-Onset Type 2 Diabetes Mellitus in the United States. 2020. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1592171636938994.

    MLA Style (8th edition)

  • Damachi, Udim. "Treatment Trends for Youth-Onset Type 2 Diabetes Mellitus in the United States." Master's thesis, University of Cincinnati, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1592171636938994

    Chicago Manual of Style (17th edition)