Gender Disparities in type 2 Diabetes Medication Utilization: A Population Based Study Using Medicaid Data

The prevalence of type 2 diabetes (T2DM) is increasing dramatically in the U.S. In some disease management evaluations, gender disparities have been discovered in the quality of care given. However, no studies to this point have shown gender disparities in medication use in patients with T2DM. The aim of this study is to investigate gender disparities in medication utilization of a 12DM population and identify possible determinants that influence medication utilization. This study will use a retrospective observational study design of all incident T2DM patients found in the Kentucky Medicaid population in the period July 1998 to December 2006. Determinants that may influence medication utilization include geography (rural/urban) and patient comorbidities. The health outcomes that will be evaluated include time to blood-glucose control and patient adherence to prescribed pharmacotherapy. The percentage of subjects given metformin (the first-line recommendation for diabetes care) as their first antidiabetic prescription after diagnosis to those first given any other antidiabetic medication will be used as a measure of provider adherence to evidence-based guidelines. The results from this health services research could be used to inform primary care providers of gender disparities in disease management and to give a better understanding of possible factors that influence gender disparities and prescribing in the management of T2DM.