P441 CARDIO–VASCULAR RISK STRATIFICATION IN T2DIABETES IN ITALY AND USE OF NEW DRUGS (SGLT2I AND GLP1–RA):DATA FROM THE AMD ANNALS:

Abstract

Abstract The AMD Annals are an initiative of computerized data collection by the Italian diabetes services, to evaluate the quality of the care provided to people with Type 1 and Type 2 Diabetes (T2D), which has been taking place for 15 years now. In 2019 the ESC/EASD Guidelines stratifying Diabetics according to cardio–vascular risk (CV) and the latest national (July 2021) and international Guidelines (LG) put new drugs with high cardio–renal protection at the forefront, such as the SGLT2i and the GLP1–RA: the ANNALS 2021 extracted the data of the year 2019, pre–pandemic, and the collection of the year 2021 is underway. AIM OF THE STUDY was to stratify T2D according to CV risk and to evaluate the prescribing appropriateness of the new drugs according to the Italian guidelines (ISS–AMD–SID). Design and Methods The 282 diabetes centers who sent the data are equipped with information systems able to guarantee the standardized extraction of the information necessary for the creation of the AMD Data File. The data analyzed concern socio–demographic, clinical and volume of activity characteristics: 46 indicators based on Revision 8 of June 19, 2019 (AMD Annals website). Results The T2D seen in the year 2019 were 531732 (57.3% M and 42.7% F, 67.3% aged > 65 years, and 32.9% aged > 75 years). 6.5% were new diagnoses. All monitoring indicators, with favorable and unfavorable outcome, have improved compared to previous years: 52% of T2D have HbA1c <= 7.0% (53 mmol/mol), 65% have LDL cholesterol < 100 mg/dl, 53.2% have blood pressure values ​​< 140/90 mmHg, 39.5% are obese. 29.1% have GFR < 60 ml/min*1.73 m2 and 6.7% have GFR< 30 ml/min. Use of drugs: further reduction to 16.7% of the use of sulfonylureas and glinides; stable at 32% insulin; new drugs are on the rise (DPPIVi: 22%; GLP1–RA: 15.9%; SGLT2i: 16.6%). Risk stratification according to the ESC/EASD classifies 20.8% of T2DM at high and 78.6% at very high CV risk and only 0.6% are at moderate risk, but only 32.5% of patients are treated with cardio–renal protection drugs. Conclusions The 2019 AMD Annals show an overall improvement in the quality of care provided, and a doubling of the use of new drugs, but we are still far from the appropriateness of treatment according to the new Italian guidelines of 2021. We hope that the 2022 Annals campaign, which has just finished, will offer a change of roote