Trends in the Prevalence and Treatment of Diabetic Macular Edema and Vision-Threatening Diabetic Retinopathy Among Commercially Insured Adults Aged <65 Years

Details

• Alternative Title:
  Diabetes Care
• Personal Author:
  Lundeen, Elizabeth A. ; Kim, Minchul ; Rein, David B. ; Wittenborn, John S. ; Saaddine, Jinan ; Ehrlich, Joshua R. ; Holliday, Christopher S.
• Description:
  Objective:
  
  Examine the ten-year trend in the prevalence and treatment of diabetic macular edema (DME) and vision-threatening diabetic retinopathy (VTDR) among commercially insured adults with diabetes.
  
  Research Design and Methods:
  
  We analyzed the ten-year trend (2009–2018) in healthcare claims for adults 18–64 years using the IBM® MarketScan® Database, a national convenience sample of employer-sponsored health insurance. We included patients continuously enrolled in commercial fee-for-service health insurance for 24 months who had a diabetes ICD-9/10-CM code on ≥1 inpatient or ≥2 different day outpatient claims in the index year or previous calendar year. We used diagnosis and procedure codes to calculate the annual prevalence of patients with ≥1 claims for: 1) any DME, 2) either DME/VTDR, and 3) anti-vascular endothelial growth factor injections [anti-VEGF] and laser photocoagulation treatment, stratified by any DME, VTDR with DME, and VTDR without DME. We calculated Average Annual Percent Change (AAPC).
  
  Results:
  
  From 2009–2018, there was an increase in the annual prevalence of patients with DME/VTDR (2.1% to 3.4%; AAPC=7.5%; p<0.001) and any DME (0.7% to 2.6%; AAPC=19.8%; p<0.001). There were sex differences in the annual prevalence of DME/VTDR and any DME, with males having a higher prevalence than females. Annual claims for anti-VEGF increased among those with any DME (327%) and VTDR with DME (206%); laser photocoagulation decreased among patients with any DME (−68%), VTDR with DME (−54%), and VTDR without DME (−62%).
  
  Conclusions:
  
  Annual claims for DME/VTDR and anti-VEGF injections increased while laser photocoagulation decreased among commercially insured adults with diabetes.
  
  
• Subjects:
  Adult Angiogenesis Inhibitors Diabetes Mellitus Diabetic Retinopathy Female Humans Macular Edema Male Prevalence Visual Acuity
• Source:
  Diabetes Care. 46(4):687-696
• Pubmed ID:
  36637915
• Pubmed Central ID:
  PMC10928529
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; U01 DP006444/DP/NCCDPHP CDC HHSUnited States/ ; U01DP006444/ACL/ACL HHSUnited States/
• Volume:
  46
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:c7ca443a023dd452e141917c27655b5d89cb5811becba9d07e387ce770fc7d9f
• Download URL:
  https://stacks.cdc.gov/view/cdc/151674/cdc_151674_DS1.pdf
• File Type:
  [PDF - 707.32 KB ]