Does diabetes care differ by type of chronic comorbidity?: An evaluation of the Piette and Kerr framework.

Objective: To evaluate the relationship between diabetes care and types of comorbidity, classified by the degree to which their treatment is concordant with that for diabetes.

Research Design And Methods: Retrospective cohort study (fiscal year [FY] 2001 to FY 2004) of 42,826 veterans with new-onset diabetes in FY 2003. Veterans were classified into five chronic comorbid illness groups (CCIGs): none, concordant only, discordant only, both concordant and discordant, and dominant.

Obesity and expenditures among elderly Veterans Health Administration users with diabetes.

A retrospective cross-sectional analysis of Veterans Health Administration (VHA) administrative and Medicare fee-for-service (FFS) claims data was used to evaluate the association between body mass index (BMI) categories and expenditures among elderly VHA users with diabetes. The study sample included respondents to the 1999 Large Health Survey of Veteran Enrollees who were diagnosed with diabetes in fiscal year 1999, age 65 or older, and enrolled in Medicare FFS (N = 79,934). Types of expenditures included inpatient, outpatient, and a summation of the 2 in the fiscal year 1999.

Guideline-consistent antidepressant treatment patterns among veterans with diabetes and major depressive disorder.

Objective: This study estimated guideline-consistent antidepressant treatment of depression among veterans with diabetes and examined its variation by patient-level demographic characteristics, socioeconomic characteristics, access to care, and health status.

Methods: Data were retrospectively analyzed from Veterans Health Administration (VHA) and Medicare claims of VHA clinic users with diabetes and major depressive disorder (N=3,953). Major depression was identified by using ICD-9-CM codes 296.

Risk of stroke, heart attack, and diabetes complications among veterans with spinal cord injury.

Objectives: To compare the rates of diabetes and macrovascular conditions in veterans with spinal cord injury (SCI) and to examine variations by patient-level demographic, socioeconomic, access, and health status factors.

Design: A retrospective analysis. Diabetes status was classified by merging with diabetes epidemiology cohort using a validated algorithm.

The association between mental health functioning and nontraumatic lower extremity amputations in veterans with diabetes.

Objective: The objective of this study was to evaluate the association between mental health functioning and lower extremity amputations (LEAs) in veterans with diabetes.

Method: A retrospective study of 1999 Large Veteran Health Survey (LVHS) respondents with diabetes who were Veterans Health Administration clinic users in fiscal years (FYs) 1998-2000 was performed. The outcome measure was type of LEAs (major, minor and none) in FY 2000.

Impact of oral antihyperglycemic therapy on all-cause mortality among patients with diabetes in the Veterans Health Administration.

Objective: The objective of this analysis was to evaluate the impact of several classes of oral antihyperglycemic therapy relative to sulfonylurea monotherapy on all-cause mortality among a cohort of patients with diabetes from the Veterans Health Administration (VHA).

Research Design And Methods: A retrospective cohort study using data obtained from the VHA Diabetes Epidemiology Cohort was used. Users of oral antihyperglycemic therapy were classified into the following cohorts: sulfonylurea monotherapy, metformin monotherapy, metformin plus sulfonylurea, thiazolidinedione (TZD) use alone or in combination with other oral agents (TZD users), and no drug therapy.

Initial nontraumatic lower-extremity amputations among veterans with diabetes.

Research Objective: We sought to identify initial nontraumatic lower-extremity amputations (ILEAs) and compare rates of ILEAs with different coding algorithms and varying lengths of observation period prior (look-back) to the first observed amputation.

Study Design: We used a retrospective design on merged Medicare claims and patient treatment files of the Veteran Healthcare Administration for fiscal years 1998 to 2000 of veterans with diabetes ages 18 years and older. Three different algorithms using least-inclusive to most-inclusive procedure codes and "look-back" periods of 12, 18, and 24 months were used to identify ILEAs.

Are there gender differences in diabetes care among elderly Medicare enrolled veterans?

Objective: To examine gender differences in diabetes care process measures and intermediate outcomes among veteran clinic users.

Design: A retrospective cohort study using Veterans Health Administration (VHA) and Medicare files of VHA clinic users with diabetes. Diabetes care process measures were tests for hemoglobin A1c (HbA1c), low-density lipoprotein (LDL-C) values, and eye exams.