Table 3

Factors associated with insulin and sulfonylurea use among US adults with diabetes

Sulfonylurea (no insulin)Insulin (±sulfonylurea)
OR (95% CI)P valueOR (95% CI)P value
Age groups
 18–44 yearsRefRef
 45–64 years1.09 (1.03 to 1.14)0.0020.94 (0.89 to 0.99)0.03
 65–74 years1.27 (1.20 to 1.34)<0.0010.72 (0.68 to 0.77)<0.001
 ≥75 years1.36 (1.29 to 1.44)<0.0010.51 (0.48 to 0.54)<0.001
Gender
 MaleRefRef
 Female0.80 (0.78 to 0.82)<0.0011.10 (1.07 to 1.13)<0.001
Race
 WhiteRefRef
 Black1.01 (0.98 to 1.04)0.701.00 (0.97 to 1.04)0.89
 Hispanic1.18 (1.15 to 1.22)<0.0010.86 (0.83 to 0.89)<0.001
 Asian1.23 (1.17 to 1.28)<0.0010.59 (0.55 to 0.62)<0.001
 Unknown0.95 (0.90 to 1.00)0.060.76 (0.72 to 0.82)<0.001
Household income
 <$40 000RefRef
 $40 000–$49 9991.00 (0.96 to 1.04)0.910.88 (0.84 to 0.92)<0.001
 $50 000–$59 9990.97 (0.94 to 1.01)0.190.88 (0.84 to 0.92)<0.001
 $60 000–$74 9990.93 (0.89 to 0.96)<0.0010.89 (0.85 to 0.93)<0.001
 $75 000–$99 9990.93 (0.90 to 0.97)<0.0010.84 (0.80 to 0.87)<0.001
 ≥$100 0000.85 (0.82 to 0.88)<0.0010.83 (0.80 to 0.86)<0.001
 Unknown0.90 (0.85 to 0.94)<0.0010.97 (0.92 to 1.02)0.20
HbA1c range
 ≤5.6%0.52 (0.49 to 0.56)<0.0010.43 (0.39 to 0.46)<0.001
 5.7%–6.4%0.60 (0.58 to 0.61)<0.0010.48 (0.46 to 0.50)<0.001
 6.5%–6.9%RefRef
 7.0%–7.9%1.46 (1.42 to 1.51)<0.0012.41 (2.32 to 2.50)<0.001
 8.0%–8.9%1.37 (1.32 to 1.42)<0.0015.21 (5.00 to 5.43)<0.001
 9.0%–9.9%1.13 (1.08 to 1.19)<0.0017.82 (7.43 to 8.23)<0.001
 ≥10.0%0.99 (0.94 to 1.04)0.739.43 (8.97 to 9.90)<0.001
Type and degree of multimorbidity
 Concordant comorbidities
  0RefRef
  11.02 (0.99 to 1.06)0.241.45 (1.39 to 1.51)<0.001
  20.96 (0.92 to 1.00)0.032.79 (2.66 to 2.93)<0.001
  ≥30.76 (0.73 to 0.79)<0.0015.50 (5.22 to 5.79)<0.001
 Discordant comorbidities
  0RefRef
  10.89 (0.87 to 0.91)<0.0011.17 (1.14 to 1.20)<0.001
  20.76 (0.72 to 0.79)<0.0011.37 (1.31 to 1.43)<0.001
  ≥30.70 (0.64 to 0.76)<0.0011.72 (1.60 to 1.86)<0.001
 Advanced comorbidities
  0RefRef
  10.90 (0.87 to 0.93)<0.0011.24 (1.20 to 1.29)<0.001
  ≥20.86 (0.74 to 1.01)0.061.45 (1.25 to 1.68)<0.001
  • Two multivariable logistic regression analyses examined the odds of (1) sulfonylurea without insulin and (2) insulin with or without sulfonylurea use controlling for patient age, sex, race/ethnicity, annual household income, glycosylated hemoglobin (HbA1c) level, and type of comorbidity profile. In each model, comorbidity burden was reflected by the number of comorbidities within each comorbidity category (ie, diabetes concordant, discordant, and advanced).