Evidence map›Paper›PMID 39746142›Full record

ArticleDiabetes care2025

The Association Between Cost-Related Insulin Rationing and Health Care Utilization in U.S. Adults With Diabetes.

Caroline G Borden, Baylee F Bakkila, Laura M Nally, Kasia J Lipska

Abstract read
In one paragraph

Article in Diabetes care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Caroline G BordenYale School of Medicine, New Haven, CT.ORCID 0000-0001-9360-5049
Baylee F BakkilaYale School of Medicine, New Haven, CT.ORCID 0000-0001-9506-1831
Laura M NallySection of Pediatric Endocrinology, Department of Pediatrics, Yale School of Medicine, New Haven, CT.ORCID 0000-0003-4349-4808
Kasia J LipskaSection of Endocrinology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT.ORCID 0000-0002-0348-742X

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Yale Diabetes Research CenterP30DK045735 · NIDDK · YALE UNIVERSITY · PI Kevan C Herold, GERALD I SHULMAN · 1993 to 2026
$44.0M
QBSafe: a randomized trial of a novel intervention to improve care for people living with type 2 diabetes.R01DK129616 · NIDDK · YALE UNIVERSITY · PI LIPSKA, KASIA JOANNA · 2022 to 2024
$840k
NCATS NIH HHS UL1 TR001863NIDDK NIH HHS P30 DK045735NIDDK NIH HHS R01 DK129616NIDDK NIH HHS R01DK129616Yale School of Medicine
6 · The paper itself

Abstract

objectiveTo examine the association between insulin rationing and health care utilization. RESEARCH DESIGN AND

methodsCross-sectional study of all 2021 National Health Interview Survey respondents with diabetes using insulin. Logistic regression and zero-inflated negative binomial regression models examined associations between insulin rationing (skipping, delaying, or reducing insulin to save money) and 1) emergency department (ED) visit or hospitalization and 2) number of urgent care visits. All analyses were age-stratified and used survey weights.

resultsAmong 982 respondents representing 7,593,944 U.S. adults (median age 61 years, 47% women), 17% reported rationing. Among adults 18-64 years old, rationing was not significantly associated with health care utilization. Among adults ≥65 years old, rationing was associated with more urgent care visits (relative risk 2.1, 95% CI 1.2-3.6) but not with odds of ED visit or hospitalization (odds ratio 0.7, 95% CI 0.3-1.4).

conclusionsInsulin rationing was not associated with higher health care utilization, but concurrent rationing of health care may mask a relationship.

Indexed as

Diabetes MellitusHypoglycemic AgentsInsulinPatient Acceptance of Health CareAdolescentAdultAgedCross-Sectional StudiesFemaleHospitalizationHumansMaleMiddle AgedUnited StatesYoung AdultHypoglycemic AgentsInsulin

Identifiers

PMID39746142
PMCPMC11870294

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.