Who Is Achieving Long-Term Glycemic Control? Ten-Year Trends in 531,995 Indiana Adults

Despite advances in therapies, many patients with diabetes worldwide are not meeting glycemic control targets. The objective of this study was to characterize adult patients with T2D in Indiana with respect to glycemic control over a 10-year period. We retrospectively analyzed a cohort of 531,995 patients with T2D and generated summary statistics. The success rate for achieving glycemic control (A1c <7 [<65 y/o] or <8 [>=65 y/o]) was defined as (number of A1c tests meeting target) / (number of A1c tests) . Uncontrolled diabetes was defined as (number of A1c tests >8) / (number of A1c tests) . We summarized 1,868,1year-level A1c observations from 20to 2018 by gender, age, and race. In four years within the 10-year period, rates of glycemic control decreased from 68% to 65% with inconsistent year-to-year change of 0.4-1.8%. The rate of uncontrolled diabetes increased from 19% to 23%. Females were more successful than males (67-71% vs. 62-66%) in achieving control.t4 Patients >=65 y/o had the highest success rate (82-88%) , while 49% to 60% of younger patients were controlled. Whites had higher success (67-70%) and less uncontrolled diabetes (17-22%) than other races.t7 Blacks’ rates of success and uncontrolled diabetes were stable at ∼46%t6 and ∼27%, respectively.t7 Black males 18-44 y/o had the lowest success rate (40-45%) . Long-term rates of achieving glycemic control in adults with T2D in Indiana declined over a 10-year period. However, one third to one half of those aged >=65 y/o achieved a high success rate for glycemic control (>80%) . Achieving longitudinal glycemic control is least successful for male blacks aged 18-44. There is a need for diabetes health service research to study population health interventions tailored by age and race. Disclosure H.N.Fu: None. T.S.Hannon: Advisory Panel; Eli Lilly and Company. M.Weiner: Stock/Shareholder; AbbVie Inc., Accuray, Inc., Allscripts Healthcare Solutions, Amgen Inc., Boston Scientific Corporation, Bristol-Myers Squibb Company, Crispr Therapeutics Ag Com, Express Scripts Hdlg Co, General Electric Co., Globus Med, Inc., IBM, Integer Hldgs Corp Com, Integra Lifesciences Holdings Corp, Johnson & Johnson, Mallinckrodt PLC, Mead Johnson & Company, LLC., Medtronic, Metlife Inc Com, Mylan N.V., Novo Nordisk A/S, Nuvasive, Inc., Orthofix Medical Inc., Perspecta Inc Com, Pfizer Inc., Resmed, Inc., Roche Pharmaceuticals, Seaspine Hldgs, Inc., Senseonics, Stryker Corp., Teva Pharmaceutical Industries Ltd., Varex Imaging Corp., Varian Med Sys, Inc., Walgreens Boots Alliance, Inc. P.Balius: None. J.Wolfson: None. T.Schleyer: None. Funding T15LM012502, UL1TR002529, the Lilly Endowment