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Table 5 Multivariable analysis of factors associated with insulin discontinuation

From: Reasons for discontinuing insulin and factors associated with insulin discontinuation in patients with type 2 diabetes mellitus: a real-world evidence study

Characteristic Labs Multiply Imputed
(7009 patients)
Labs Not Included
(7009 patients)
Patients with Missing Labs Not Included
(2790 patients)
OR (95% CI) P-value OR (95% CI) P-value OR (95% CI) P-value
Age 0.99 (0.99–0.99) 0.022 0.99 (0.99–0.99) 0.02 0.99 (0.99–1.01) 0.44
Female 1.1 (0.95–1.2) 0.28 1.1 (0.95–1.2) 0.28 1.02 (0.85–1.2) 0.83
Race
 African-American 0.98 (0.84–1.2) 0.83 0.98 (0.84–1.2) 0.83 0.81 (0.62–1.06) 0.12
 Asian 1.1 (0.86–1.5) 0.41 1.1 (0.86–1.5) 0.41 0.98 (0.67–1.4) 0.91
 Hispanic 0.95 (0.80–1.1) 0.55 0.95 (0.80–1.1) 0.55 0.93 (0.70–1.2) 0.62
 Other 1.1 (0.87–1.3) 0.55 1.1 (0.87–1.3) 0.55 1.1 (0.80–1.4) 0.62
Married 1.01 (0.91–1.1) 0.79 1.01 (0.91–1.1) 0.79 1.02 (0.86–1.2) 0.85
Median household income by zip code 1.00 (1.00–1.00) 0.21 1.00 (1.00–1.00) 0.21 1.02 (1.00–1.1) 0.32
Smoking history 1.01 (0.91–1.1) 0.87 1.01 (0.91–1.1) 0.87 1.1 (0.93–1.3) 0.27
CAD 0.98 (0.86–1.1) 0.78 0.98 (0.86–1.1) 0.78 1.01 (0.82–1.3) 0.92
Stroke 1.3 (1.0–1.7) 0.02 1.3 (1.0–1.7) 0.02 1.7 (1.2–2.5) 0.0017
PVD 0.83 (0.68–1.02) 0.08 0.83 (0.68–1.02) 0.08 0.78 (0.58–1.1) 0.11
HTN 0.96 (0.84–1.1) 0.61 0.96 (0.84–1.1) 0.61 0.84 (0.67–1.1) 0.16
Depression 1.03 (0.90–1.2) 0.70 1.03 (0.90–1.2) 0.70 0.12 (0.97–1.4) 0.10
Bipolar 1.25 (0.91–1.7) 0.17 1.25 (0.91–1.7) 0.17 1.3 (0.83–2.1) 0.24
Schizophrenia 0.84 (0.53–1.3) 0.44 0.84 (0.53–1.3) 0.44 0.75 (0.39–1.5) 0.40
Hypoglycemia 0.99 (0.63–1.6) 0.98 0.99 (0.63–1.6) 0.98 0.66 (0.31–1.4) 0.30
CCI 1.03 (1.01–1.05) 0.003 1.03 (1.01–1.05) 0.003 1.01 (0.98–1.04) 0.62
BMI Increase 0.61 (0.50–0.74) <  0.001 0.61 (0.50–0.74) <  0.001 0.57 (0.43–0.77) 0.0003
Number of DM non-insulin meds 0.97 (0.92–1.02) 0.27 0.97 (0.92–1.02) 0.27 0.99 (0.91–1.1) 0.95
Number of non-DM meds 1.01 (1.00–1.03) 0.04 1.01 (1.00–1.03) 0.04 1.01 (0.99–1.03) 0.32
Adverse Reactions to non-insulin meds 1.00 (0.98–1.02) 0.91 1.00 (0.98–1.02) 0.91 0.99 (0.96–1.03) 0.78
SBP 1.00 (0.99–1.00) 0.93 1.00 (0.99–1.00) 0.93 1.00 (0.99–1.01) 0.26
DBP 0.99 (0.99–1.00) 0.99 0.99 (0.99–1.00) 0.99 0.99 (0.99–1.01) 0.90
HbA1c 1.06 (1.02–1.1) 0.005    1.1 (1.05–1.1) <  0.001
LDL 0.99 (0.99–1.00) 0.71    1.00 (0.99–1.00) 0.98
eGFR 1.00 (0.99–1.00) 0.31    1.00 (0.99–1.01) 0.65
Encounter frequency 0.99 (0.98–0.996) 0.004 0.99 (0.98–0.996) 0.004 0.99 (0.98–1.01) 0.25
Nurse practitioner 0.90 (0.77–1.04) 0.16 0.90 (0.77–1.04) 0.16 0.69 (0.44–1.1) 0.10
Provider specialty
 Endocrinology 2.6 (2.2–3.0) <  0.001 2.6 (2.2–3.0) <  0.001 2.0 (1.6–2.6) <  0.001
 Other 1.3 (1.1–1.5) <  0.001 1.3 (1.1–1.5) <  0.001 1.1 (0.88–1.4) 0.44
Provider female 1.2 (1.1–1.4) <  0.001 1.2 (1.1–1.4) <  0.001 1.2 (1.00–1.4) 0.044
Provider diabetes experiencea 0.93 (0.90–0.96) <  0.001 0.93 (0.90–0.96) <  0.001 0.97 (0.93–1.02) 0.24
Insulin regimenb
 Basal-bolus 1.6 (1.3–1.8) <  0.001 1.6 (1.3–1.8) <  0.001 1.5 (1.1–2.0) 0.003
 Bolus only 1.2 (1.04–1.4) 0.01 1.2 (1.04–1.4) 0.01 1.2 (0.91–1.5) 0.22
 Mixed 1.2 (0.92–1.6) 0.16 1.2 (0.92–1.6) 0.16 1.3 (0.88–2.0) 0.18
Commercial EMR 0.53 (0.40–0.71) <  0.001 0.53 (0.40–0.71) <  0.001 0.68 (0.45–1.04) 0.08
  1. Labs Multiply Imputed represents the model (primary analysis) where all patients were included and missing HbA1c, LDL and eGFR data were accounted for by multiple imputation
  2. Labs Not Included represents the model where all patients were included but HbA1c, LDL and eGFR variables were not included in the model
  3. Patients with Missing Labs Not Included represents the model where patients who missing either HbA1c, LDL or eGFR data were not included in the model (2790 patients were included)
  4. aPer 100 patients seen annually
  5. bCompared to basal insulin regimen