Geographic Disparities in Glucagon Prescriptions Across North Carolina.

Abstract

Geographic disparities in healthcare access cause substantial difficulties for patients with diabetes, particularly in accessing emergency medicines such as glucagon. In this study, the authors examine the spatial distribution of glucagon, insulin, and sulfonylureas prescription claims for Medicaid recipients in North Carolina counties and consider how these differences affect the management of diabetes and public health policy. Glucagon, insulin, and sulfonylureas claim counts in each North Carolina county as reported by the North Carolina Medicaid from January 2022 to July 2023 were used. The authors also used the medical provider density data, county classification data, and pharmacy data, all at the county level, for the state of North Carolina. The authors compared prescribing patterns across urbanicity categories using descriptive statistics and investigated spatial patterns using data visualization. Of the 100 North Carolina counties, 38% had zero glucagon claims reported, and all were rural counties. The average number of claims was higher in urban counties than in rural counties: insulin (922.2 vs 120.7), glucagon (123.7 vs 14.6), and sulfonylureas (10.0 vs 2.8). The study revealed significant disparities in diabetes care across North Carolina, with rural counties reporting the lowest glucagon, insulin, and sulfonylureas claims. Urban counties had higher healthcare provider densities and medication claims, with urban areas being 7.6 times more likely to report insulin claims than rural areas, highlighting geographic inequities in care access. By emphasizing the significance of addressing glucagon prescribing trends, this analysis recommends focused efforts to promote the equitable distribution of life-saving medicines for severe hypoglycemia.