Johnston SS, et al. - In this retrospective study that consisted of 13,026 overweight or obese patients with antihyperglycemic-treated type 2 diabetes, researchers investigated the link between body mass index (BMI) and insulin use with type 2 diabetes-related healthcare expenditures (T2D-HE). The analyzed de-identified electronic health records linked to insurance claims data. Via multivariable regressions, they evaluated 1-year follow-up T2D-HE as a function of BMI, insulin use, an interaction term between BMI and insulin use, and patient demographics. Baseline insulin use rates ranged from 19.7% in overweight candidates to 33.0% in obese class III (OCIII) patients. Both BMI and insulin use were jointly linked to 1-year follow-up T2D-HE, which monotonically ranged from $5,842 in overweight patients with no insulin to $17,700 OCIII insulin users. The investigators concluded that BMI and insulin may have clinical utility as simple stratifiers for identifying high-cost patients. Because OCIII insulin users incurred the greatest annual healthcare expenditures, they may be an ideal group for targeted interventions.