1418-P: Identification and Follow-up of T2D by Subtypes and Their Cardiovascular Risk in Mexican Population—The Experience of the MIDO State Registry in Guanajuato

Abstract

Type 2 diabetes (T2D) is a complex and heterogeneous disease that has been categorized based on its underlying physiological mechanisms to inform treatment strategies. However, patients with T2D often exhibit a wide range of phenotypic and metabolic profiles, and the subclassification of this disease has only recently been developed, enabling the possibility of personalized management and improved outcomes. The aim of this research was to identify and follow-up T2D subtypes and their cardiovascular risk (CVR) in the Mexican population. In this study, 14,124 patients with incident T2D were assessed to characterize their phenotypic and metabolic profiles and to identify their CVR as part of the MIDO State Registry in Guanajuato, Mexico between April 2014, and April 2022. Of the 14,124 patients with incident T2D, when clustered into subtypes according to their phenotypic and metabolic profile, 3,530 (24.9%) belonged to the mild age-related diabetes (MARD) subtype, 4,304 (30.5%) to the mild obesity-related diabetes (MOD), 3,180 (22.1%) to the severe autoimmune diabetes (SIRD), and 3,111 (11.5%) to the severe insulin-resistant diabetes (SIDD). When the CVR was assessed, 1,767 (50.1%) individuals had a medium CVR and 1,763 (49.9%) had a high CVR in the MARD, 3,313 (76.9%) had a medium CVR and 990 (23.1%) had a high CVR in the MOD, 1,699 (54.6%) had a medium CVR and 1,733 (45.4%) had a high CVR in the SIRD, and 2,290 (72.0%) had a medium CVR and 890 (27.9%) had a high CVR in the SIDD. Of the 13,192 patients that were followed for 6 months, up to 61.0% of the MARD, 61.4% of the MOD, 61.2% of the SIRD, and 40.9% of the SIDD achieved metabolic control (HbA1c <7%). Classifying the subtypes of T2D allows for the design of personalized treatment strategies aiming to delay the progression of the disease and prevent cardiovascular complications. In Mexico, this is a novel approach that seeks to improve the overall outcomes of patients with incident T2D. Disclosure H.Gallardo-rincón: None. R.Tapia-conyer: None. A.Montoya: None. L.Morales-juarez: None. M.J.Rios-blancas: None. D.Álvarez-hernández: None. L.Martinez-juarez: None. D.Diaz-martínez: None. F.Magos-vazquez: None. E.Vargas: None.