1563-P: Multimorbidity and Its Associations with All-Cause Mortality in People with Type 2 Diabetes: A Prospective Analysis of the UK Biobank

Abstract

Introduction: The emerging interest in multimorbidity (MM) in people with type 2 diabetes (T2D), which can be concordant (T2D-related) or discordant (unrelated), suggests the need to understand the burden of MM in T2D, and its association with all-cause mortality. We explored associations between MM conditions counts (total, concordant and discordant) and all-cause mortality in people with T2D in the UK Biobank. Methods: We examined data from a longitudinal cohort of 20,569 people with T2D in the UK Biobank recruited between 2006-2010. The number of MM conditions in addition to T2D was the primary independent variable based on self-report and hospital admissions data. All-cause mortality was the primary outcome. Multivariable Cox proportional hazard regression was used to examine associations between each of the MM counts and mortality. Results: A significant association between increasing MM and mortality was found. Compared to those with T2D with no additional chronic conditions, having 1, 2, 3 and 4+ conditions in addition to T2D, the HRs (95% CI) for all-cause mortality were 1.23 (0.90-1.68), 1.84 (1.36-2.49), 1.91 (1.40-2.60), and 3.13 (2.33-4.20), respectively. Both concordant and discordant conditions were significantly associated with mortality. For 1, 2, 3 and 4+ concordant conditions in addition to T2D, the HRs (95% CI) were 1.23 (1.04-1.48), 1.76 (1.46-2.13), 2.78 (2.22-3.48), and 4.25 (3.23-5.59), respectively and for discordant conditions 1.32 (1.13-1.55), 1.46 (1.23-1.74), 1.77 (1.45-2.17), and 2.44 (2.01-2.99), respectively. Conclusions: The association between MM and mortality is significant for total, concordant and discordant condition count, but was strongest for concordant. Our findings emphasize the need for clinical guidelines and future MM measures to consider MM in people with T2D, both concordant and discordant. Disclosure J.I. Chiang: None. P. Hanlon: None. B.D. Jani: None. J.E. Manski-Nankervis: Research Support; Self; Australian National Health and Medical Research Council, Boehringer Ingelheim International GmbH, Diabetes Australia, Eli Lilly and Company. Speaker's Bureau; Self; RACGP. J. Furler: Research Support; Self; Abbott, Sanofi. B.I. Nicholl: None. F.S. Mair: None.