1024-P: Management Algorithm of Patients with Concomitant Diabetes Mellitus and Chronic Venous Insufficiency

Abstract

Introduction: Diabetes mellitus (DM) and Chronic Venous Insufficiency (CVI) are significant burden in patient daily life. While the two diseases share common risk factors and pathophysiology, they are often assessed and managed as separate conditions. Aim: To develop recommendations for the identification and treatment of patients with concomitant DM and CVI. Methods: Using a modified Delphi method, a panel of experts developed 38 statements and 2 multiple choice questions. These were used to form an online survey which was disseminated through vascular and diabetes specialists across Europe, Central America, South America, and Middle East. Respondents indicated their level of agreement with each statement. The threshold for consensus was set as ≥75% of agreement. Results: A total of 238 responses were received. Most of the statements (27/38) reached >90% agreement, 9/38 attained between 75-90% agreement, and 2 failed to meet the threshold. The awareness around the impact of the two diseases was high and a gap was highlighted in the identification of patients suffering from concomitant DM and CVI. Seventy-seven (77%) respondents consider overweight (BMI >30) and leg oedema as signs for assessment of the presence of DM and diabetic microvascular complications (DmVC) in patients with CVI, while 63% agreed that three parameters (skin changes, leg burden and oedema) would be required to trigger investigation for coexistent CVI in patients with DM. Treatment of patients with DmVC and CVI should be accomplished with a combination approach, including lifestyle change, non-medical and pharmacological treatments. Venoactive drugs indicated in both DmVC and CVI were recognized as treatment option in this patient population. Conclusion: These results raised the need to consider DM and CVI as a combined therapy area. As outcome, an algorithm is proposed to help the identification of at-risk patients and to provide recommendation on the management of patients with concomitant diseases. Disclosure G.Gastaldi: Advisory Panel; Ascensia Diabetes Care, Insulet Corporation, Novo Nordisk, Lilly, Other Relationship; Abbott Diabetes, AlfaSigma, Research Support; Ypsomed AG, Speaker's Bureau; Dexcom, Inc., Medtronic, Roche Diabetes Care. A.K.Bozkurt: Advisory Panel; OM PHARMA. M.Van rijn: None. E.Bouskela: None. F.Glauser: Consultant; Servier Laboratories. E.Rabe: Consultant; Sigvaris Int., EUROCOM, Mylan, Speaker's Bureau; OM Pharma. A.Mansilha: None. H.Haller: None. J.Rosas-saucedo: None. Funding OM Pharma Ltd.