Tanima Banerjee’s research while affiliated with Concordia University Ann Arbor and other places

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Publications (3)


Interruptions In Private Health Insurance And Outcomes In Adults With Type 1 Diabetes: A Longitudinal Study
  • Article

July 2018

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32 Reads

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26 Citations

Health Affairs

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Joyce M. Lee

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[...]

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Catherine Kim

Type 1 diabetes mellitus, which often originates during childhood, is a lifelong disease that requires intensive daily medical management. Because health care services are critical to patients with this disease, we investigated the frequency of interruptions in private health insurance, and the outcomes associated with them, for working-age adults with type 1 diabetes in the United States in the period 2001-15. We designed a longitudinal study with a nested self-controlled case series, using the Clinformatics Data Mart Database. The study sample consisted of 168,612 adults ages 19-64 with type 1 diabetes who had 2.6 mean years of insurance coverage overall. Of these adults, 24.3 percent experienced an interruption in coverage. For each interruption, there was a 3.6 percent relative increase in glycated hemoglobin. The use of acute care services was fivefold greater after an interruption in health insurance compared to before the interruption and remained elevated when stratified by age, sex, or diabetic complications. An interruption was associated with lower perceived health status and lower satisfaction with life. We conclude that interruptions in private health insurance are common among adults with type 1 diabetes and have serious consequences for their well-being.


Duration of Insulin Supply in Type 1 Diabetes—Is 90 Days Better or Worse than 30 Days?

May 2018

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14 Reads

Diabetes

We evaluated whether the duration of insulin supply was associated with hemoglobin A1c. Data were obtained through the Clinformatics® Data Mart Database, from 2001-2015. Patients were grouped according to the duration of insulin supply: 30 days, 90 days, and a combination of both 30 day and 90 day prescriptions. Generalized estimating equations which account for repeated measures within patients were used, with robust estimates of variance. Prescription duration was regressed on HbA1c (dependent variable) with alpha=0.(2-tailed). There were 16,725 eligible patients (9362 with 30-day, 1280 with 90-day, and 6083 with both 30- and 90-day prescriptions). The mean number of HbA1c tests/patient was 3.1. Patients who used 30-day prescriptions had HbA1c values that were 0.65 greater than those with 90-day prescriptions (p<0.001). Patients who used a combination of 30-day and 90-day prescriptions had HbA1c values that were 0.37 greater compared to 90-day prescriptions (p<0.001). The predicted HbA1c values were 8.33% (95% CI: 8.31%, 8.36%) for 30-day, 8.05% (95% CI: 8.03%, 8.08%) for the combination, and 7.69% (95% CI: 7.64%, 7.73%) for 90-day prescriptions. Results were similar when stratified by age. For those <20 years of age, the predicted HbA1c values were 8.95% for 30-day, 8.71% for the combination, and 8.33% for 90-day prescriptions. For those ≥20 years of age, the results were 8.26%, 7.96% and 7.64%, respectively. Patterns were similar when stratified by sex. Mailed prescriptions were also associated with lower HbA1c (p<0.001). Predicted HbA1c was 7.58% (95% CI: 7.53%, 7.63%) when all prescriptions were mailed and 8.21% (95% CI: 8.19%, 8.23%) when not. After simultaneous adjustment for age, sex, duration of supply, and mailed status, both 90-day prescriptions and mailed prescriptions were associated with lower HbA1c values (p<0.001 for both). In patients with type 1 diabetes, 90-day insulin prescriptions and mailed prescriptions were both independently associated with lower HbA1c values. Disclosure M.A.M. Rogers: None. C. Kim: None. R. Tipirneni: None. T. Banerjee: None. J. Lee: Consultant; Self; Unitio.


Fig. 1 Incidence rates for type 1 diabetes by age at diagnosis and sex, United States, 2001-2015 
Table 1 Incidence of type 1 diabetes mellitus and characteristics when first diagnosed by age category, 2001-2015
Fig. 2 Incidence of type 1 diabetes in Northeastern United States by year 
Table 2 Sensitivity analyses for the incidence of type 1 diabetes mellitus in the United States by age category, 2001-2015 Vanderloo algorithm a Rapid onset b Age category, years c N, incident cases Incidence rate d 95% Confidence intervals N, incident cases Incidence rate d 95% Confidence intervals
Fig. 3 Incidence of type 1 diabetes in Midwestern United States by year 

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Fluctuations in the incidence of type 1 diabetes in the United States from 2001 to 2015: A longitudinal study
  • Article
  • Full-text available

November 2017

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3,300 Reads

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170 Citations

BMC Medicine

Abstract Background While the United States has the largest number of children with type 1 diabetes mellitus, less is known regarding adult-onset disease. The present study utilizes nationwide data to compare the incidence of type 1 diabetes in youth (0–19 years) to that of adults (20–64 years). Methods In this longitudinal study, the Clinformatics® Data Mart Database was used, which contains information from 61 million commercially insured Americans (years 2001–2015). Incidence rates and exact Poisson 95% confidence intervals were calculated by age group, sex, census division, and year of diagnosis. Changes in rates over time were assessed by negative binomial regression. Results Overall, there were 32,476 individuals who developed type 1 diabetes in the cohort. The incidence rate was greatest in youth aged 10–14 years (45.5 cases/100,000 person-years); however, because adulthood spans over a longer period than childhood, there was a greater number of new cases in adults than in youth (n = 19,174 adults; n = 13,302 youth). Predominance in males was evident by age 10 and persisted throughout adulthood. The male to female incidence rate ratio was 1.32 (95% CI 1.30–1.35). The incidence rate of type 1 diabetes in youth increased by 1.9% annually from 2001 to 2015 (95% CI 1.1–2.7%; P

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Citations (2)


... Insurance status can modify health outcomes for people with diabetes [16,37,38]. We found that the gender differences in insufficient physical activity existed whether they were insured or not, while the gender differences in sedentary behavior exist only in the insured group. ...

Reference:

Gender Differences in Unhealthy Lifestyle Behaviors among Adults with Diabetes in the United States between 1999 and 2018
Interruptions In Private Health Insurance And Outcomes In Adults With Type 1 Diabetes: A Longitudinal Study
  • Citing Article
  • July 2018

Health Affairs

... Patient-centred approaches are established in paediatric T1D care but are less explored in adults [7,8]. Once considered a childhood condition, recent data show similar rates in adults and children [9]. As complications increase with age, there is a need to better understand adult T1D care experiences to inform quality improvement [10,11]. ...

Fluctuations in the incidence of type 1 diabetes in the United States from 2001 to 2015: A longitudinal study

BMC Medicine