1687-P: An Examination of Clinical Outcomes in People with T1D and Obesity

Abstract

A lack of knowledge exists concerning how best to treat type 1 diabetes (T1D) and obesity simultaneously. This cross-sectional study examined whether people with T1D and obesity have differences in the prevalence of outcomes, treatment methods, and healthcare utilization. The data were pulled from the electronic medical record for 1546 patients with T1D (≥ 18 years) seen at NorthShore University HealthSystem during 2017. The study population was 53% female; mean age was 46.4 ± 18.0 years. About 32% of patients had a normal weight (BMI 20-24.99) and 28% of patients had obesity (BMI ≥ 30). The patients with obesity were compared to the patients with normal weight (NW).There was a significantly higher prevalence of hypertension (p<0.001) and depression (p=0.038) among patients with obesity compared to patients with NW. No significant difference in the prevalence of other comorbidities (heart failure, myocardial infarction, cancer, dementia, peripheral vascular disease, chronic kidney disease, stroke) were observed. Patients with obesity had a significantly higher rate of retinopathy, neuropathy, and microalbuminuria (p<0.0001, p=0.005, p=0.005, respectively) compared to patients with NW. Adjusted for age, sex, and years of T1D duration, patients with obesity were 57%, 92%, and 60% more likely to have neuropathy, retinopathy, and microalbuminuria, respectively, than NW patients. There were no difference in mean HbA1C or total cholesterol level between the groups. Adjusted for age, sex, and years of T1D duration, the use of an insulin pump was not associated with BMI. Patients with obesity attended more outpatient visits in 2017 than NW patients (p=0.001), but did not differ in ER or inpatient visits. The higher rate of diabetes-related outcomes, hypertension, depression and healthcare utilization among T1D patients with obesity, compared to those of NW provide the impetus for further investigation into how best to treat patients with T1D and obesity to prevent the disparities in outcomes elucidated by this study. Disclosure E.R. Stewart: None. A.M. Monie: None. L.K. Billings: Advisory Panel; Self; Novo Nordisk A/S, Sanofi-Aventis. Consultant; Self; Novo Nordisk A/S. Research Support; Self; Novo Nordisk A/S. Speaker's Bureau; Self; Novo Nordisk A/S.