USE AND HEALTHCARE UTILIZATION OF WEIGHT GAIN VERSUS WEIGHT LOSS/NEUTRAL ANTIHYPERGLYCEMICS AMONG PATIENTS WITH TYPE 2 DIABETES

Abstract

Background: Diabetes affects 11.3% of the US population, with 89.8% of individuals aged 18 or older being overweight or obese. About 49.4% of type 2 diabetic patients have uncontrolled glycemic control. Being overweight or obese correlates with poor glycemic control. Antihyperglycemic medications can been known to have unintended consequences of weight; some induce weight gain, are neutral, or produce weight loss. Objective: To conduct an up-to-date evaluation of the trends in use of antihyperglycemic agents and the impact on healthcare utilization, as it has not been reported. Methods: An observational study using the National Health and Nutrition Examination Survey from 2015-2016 to 2017-March 2020. Descriptive statistics were used, including count and percent to report medication use. The comparison was analyzed by using Chi-square tests for categorical variables and an independent t-tests for continuous variables to evaluate the associations of demographics, physical activity, clinical factors, and comorbidities across the weight gain/loss-neutral use groups. Univariate logistic regression models quantified the odds of being on a weight gain antihyperglycemic within population sub-groups. Uni- and multi-variable logistic regression models were used to assess the association health utilization among both groups. Results: Most of the included participants were on weight gain antihyperglycemic agents versus weight loss/neutral (56.3% vs. 43.7%). The groups taking weight gain and weight-loss/neutral antihyperglycemic agents differed significantly in terms of age, education, renal disease, hyperlipidemia, congestive heart failure, and stroke. Moreover, 61.7% of those using weight gain antihyperglycemic agents had uncontrolled blood glucose. There was no statistically significant difference between both groups and number of times receive healthcare over past year before and after adjusting for potential confounding factors. There was statistically significant difference between both groups in overnight hospital stays before adjusting for potential confounding factors, but significance was lost after adjustment of covariables were made. Conclusion: Patients on weight-loss/neutral antihyperglycemic agents presented as a “healthier” group compared with those using weight-gain antihyperglycemic agents in many factors. Additionally, there is no strong evidence to suggest that treatment with weight-gain is associated with number of times receiving health care compared to treatment with weight-loss/neutral antihyperglycemic agents after adjusting for potential confounders.