• John M Clements, Mariana Rosca, Carla Cavallin, Shelby Falkenhagen, Thomas Ittoop, Christina K Jung, Megan Mazzella, Joseph A Reed, Megan Schluentz, and Caleb VanDyke.
• Central Michigan University, College of Medicine, Mount Pleasant, Michigan. Electronic address: clemen69@msu.edu.
• Am. J. Med. Sci. 2020 Apr 1; 359 (4): 218-225.

BackgroundThis study aimed to describe the prevalence of type 2 diabetes and combinations of multiple chronic conditions (MCCs) that are leading causes of death (LCD) and confirm that disparities exist between groups based on race and sex.Materials And MethodsWe conducted a retrospective cohort study using 2012 Medicare claims data from beneficiaries with type 2 diabetes over the age of 65 in the state of Michigan.ResultsFemale beneficiaries have type 2 diabetes and 1 or more MCCs that are LCD more often than males. Most type 2 diabetes patients have diabetes alone without MCCs, while a large proportion have at least 1 additional chronic condition that is a LCD. One in 3 patients have 3 or more chronic conditions. The most prevalent type 2 diabetes coexisting MCCs are congestive heart failure (CHF), chronic obstructive pulmonary disease and chronic kidney disease. Asian/Pacific Islanders have the highest prevalence of type 2 diabetes without MCCs, and the highest prevalence of diabetes plus CHF. While fewer black beneficiaries have diabetes alone or 1 additional MCC, the prevalence of 3 or more MCCs in blacks generally exceeds the prevalence in other races. In beneficiaries with newly diagnosed type 2 diabetes, chronic obstructive pulmonary disease and CHF are the first new chronic conditions to be diagnosed after an initial type 2 diabetes diagnosis.ConclusionsRace and sex disparities occur in the prevalence of type 2 diabetes and MCCs that are LCD in Medicare beneficiaries in the state of Michigan.Copyright © 2020 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

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