Evidence map›Paper›PMID 40088385›Full record

ArticleJournal of racial and ethnic health disparities2026

Disparities in Antidiabetic Medication Discontinuation Between Non-Hispanic White and Black Beneficiaries in Medicare Across Diabetes Belt and Surrounding Area.

Peng Zhang, Jennifer Mason Lobo, Min-Woong Sohn, Rajesh Balkrishnan, Roger Anderson, Anthony McCall, Hyojung Kang

Abstract read
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In one paragraph

Article in Journal of racial and ethnic health disparities, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–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 synthesis or guideline pooled it.

  1. Pooled it
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

7 authors.

Peng ZhangDepartment of Health and Kinesiology, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, 2005 Huff Hall, 1206 S Fourth Street, Champaign, IL, 61820, USA.
Jennifer Mason LoboDepartment of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA, USA.
Min-Woong SohnDepartment of Health Management and Policy, College of Public Health, University of Kentucky, Lexington, KY, USA.
Rajesh BalkrishnanDepartment of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA, USA.
Roger AndersonDepartment of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA, USA.
Anthony McCallDepartment of Medicine, Division of Endocrinology & Metabolism, School of Medicine, University of Virginia, Charlottesville, VA, USA.
Hyojung KangDepartment of Health and Kinesiology, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, 2005 Huff Hall, 1206 S Fourth Street, Champaign, IL, 61820, USA. hyokang@illinois.edu.ORCID 0000-0001-7429-1101

Funding

Detecting, Understanding, and Reducing Diabetes Belt Preventive Care DisparitiesR01DK113295 · NIDDK · UNIVERSITY OF VIRGINIA · PI LOBO, JENNIFER MASON, SOHN, MIN-WOONG · 2018 to 2021
$2.2M
Health Care Engineering Systems Center, University of Illinois JUMP ARCHES P395NIDDK NIH HHS R01 DK113295NIDDK NIH HHS R01DK113295NIDDK NIH HHS R01DK132569-01
6 · The paper itself

Abstract

objectiveTo assess racial and geographic disparities in antidiabetic medication discontinuation among Medicare beneficiaries with type 2 diabetes (T2D) in or around Diabetes Belt (DB) areas, with a specific focus on differences between non-Hispanic (NH) white and NH Black individuals. STUDY

designA retrospective cohort analysis was conducted on Medicare beneficiaries who initiated metformin and used antidiabetic medications during 2011-2015, including metformin, sulfonylureas, insulin, DPP-4 inhibitors, GLP-1 receptor agonists, SGLT2 inhibitors, and thiazolidinediones. Medication discontinuation was defined as a gap of 90 days or more without any antidiabetic medications.

methodsMultivariable Cox regression was used to examine the influence of racial and geographic factors on medication discontinuation, controlling for demographic, socioeconomic, and contextual factors. The interaction between race and DB status was also examined.

resultsAmong 21,159 Medicare beneficiaries initiating metformin during the study period, 8710 (41.2%) experienced medication discontinuation. NH Black individuals had a significantly higher discontinuation risk (HR: 1.22, 95% CI: [1.162, 1.286]) compared to NH White individuals. No significant geographic difference (HR: 1.02, 95% CI: [0.973, 1.072]) was observed between DB and Non-Diabetes Belt (NDB). NH Black patients consistently showed significantly higher discontinuation risks within both DB and NDB. No significant difference was found within the same race across counties.

conclusionWe found significant racial but no geographic disparities in antidiabetic medication discontinuation among Medicare beneficiaries with T2D. Further research is needed to understand the underlying factors to improve equitable diabetes care management.

Indexed as

Black or African AmericanDiabetes Mellitus, Type 2Healthcare DisparitiesHypoglycemic AgentsWhite PeopleAgedAged, 80 and overFemaleHumansMaleMedicareMetforminRetrospective StudiesUnited StatesWhiteHypoglycemic AgentsMetforminDiabetesGeographic disparitiesMedicare beneficiariesMedication discontinuationRacial disparities

Identifiers

PMID40088385

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Registered trials

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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.