429-P: Therapeutic Inertia: Gap between Goals and Achievement between the T1DX and DPV Registries

Abstract

Despite increased cardiovascular (CV) mortality in people with type 1 diabetes (T1D), treatment of CV risk factors may not be optimized. International registry comparisons highlight opportunities to improve clinical care and improve outcomes. We analyzed data from 28,494 patients from the German/Austrian DPV registry and 19,442 patients from the U.S. T1D Exchange (T1DX) Clinic registry with data between 01/2016 and 03/2018. Percent of patients by age category with HbA1c <7.5%, hypertension (HTN) and its treatment, dyslipidemia and its treatment, urine albumin to creatinine ratio >30 mg/g, BMI >30 kg/m2, and current smoking are reported. Logistic regression models by age group adjusted for sex and diabetes duration were used to calculate whether registry differences existed. The prevalence of obesity is lower in the DPV than the T1DX registry (Table). In those age <26 years more DPV than T1DX patients had A1c <7.5%. Hypertension was more prevalent in the DPV for those <26 years, but less prevalent for those >50 years. Dyslipidemia was more prevalent in DPV for those <50 years, but less for those <50 years. Elevated ACR and smoking are higher and HTN and dyslipidemia treatment are lower in the DPV than in the T1DX. Vascular disease remains the leading cause of morbidity and mortality in T1D. Comparison of risk factors and their treatment in these registries highlights opportunities to improve care and outcomes. Disclosure D.M. Maahs: Advisory Panel; Self; Novo Nordisk Inc. Consultant; Self; Abbott, Sanofi. Research Support; Self; Dexcom, Inc., Tandem Diabetes Care. J. Hermann: None. N.C. Foster: None. W. Karges: None. K. Miller: None. A. Dost: None. R.S. Weinstock: Consultant; Self; Insulogic LLC. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Jaeb Center for Health Research, Kowa Pharmaceutical Europe Co. Ltd., Medtronic MiniMed, Inc., Oramed Pharmaceuticals. Other Relationship; Self; Unitio, Inc. M. Pavel: None. V.N. Shah: Advisory Panel; Self; Sanofi US. Consultant; Self; Dexcom, Inc. R.W. Holl: None. Funding The Leona M. and Harry B. Helmsley Charitable Trust; German Center for Diabetes Research; German Diabetes Association; European Foundation for the Study of Diabetes; INNODIA