Persons were assigned a diagnosis of diabetes using the following algorithm: 1) having at least two outpatient claims ≥30 days apart coded for diabetes as a primary or secondary diagnosis (International Classification of Diseases, Ninth Revision, Clinical Modification codes 250x), 2) having received prescriptions for diabetes medications, either oral agents or insulin (therapeutic class codes 172–174), or 3) having at least one inpatient admission with diabetes as a primary or secondary diagnosis. Here, INS is linked to diabetes mellitus.