MON-419 Epidemiology And Risk Factors For Hyperglycemia And Diabetes-related Complications Among Patients With Thyroid Eye Disease (TED) In The United States

Abstract Disclosure: B. Gigliotti: Amgen Inc, Immunovant, Xeris. D. Chauhan: Amgen Inc. J. Ma: None. M.R. Ochoa-Maya: Amgen Inc. H. Patel: Amgen Inc. Background: Thyroid Eye Disease (TED) is an autoimmune orbitopathy often coexisting with diabetes mellitus, with overlapping pathophysiological pathways. The burden of hyperglycemia and related complications in patients with TED remains unknown. Objectives: To describe the epidemiology and risk factors associated with hyperglycemia and diabetes-related complications in patients with TED, compared to those with Graves’ Disease (GD) and the general population (GP). Methods: We conducted a retrospective cohort study using a large U.S. claims database from January 2014 to December 2019. The age- and gender-standardized cumulative incidence (C, %), incidence rate (IR, per 10,000 person-years), and prevalence (PR, %) of a composite outcome—comprising hyperglycemia (drug-induced, diabetes-related, prediabetes, impaired fasting glucose, hyperosmolarity) and diabetes-related complications (nephropathy, neuropathy, retinopathy, or ketoacidosis)—were calculated. Multivariable Cox models estimated adjusted hazard ratios (HRs) with 95% confidence intervals (CI), controlling for age, sex, baseline comorbidities, and hyperglycemia-inducing medications. Analyses were stratified by baseline diabetes status. Results: The study included 38,723 patients with TED, 171,831 patients with GD, and over 20 million people in GP, with mean (SD) ages of 55.2 (15.5), 52.8 (15.7), and 47.4 (16.8) years, respectively. The composite outcome occurred more frequently in the TED (C: 14.9%; IR: 786; PR: 21.7%) and GD (C: 15.4%; IR: 764; PR: 20.4%) cohorts than in the GP (C: 9.6%; IR: 414; PR: 11.6%). A total of 7,657 patients (19.8%) in the TED cohort, 30,070 (17.5%) in the GD cohort, and 1,876,937 (9.3%) in GP had diabetes. The composite outcome was more frequent among TED patients with diabetes (C: 39.6%; IR: 2,690; PR: 56.1%) than among those without diabetes (C: 11.4%; IR: 575; PR: 13.5%). The adjusted HR (95% CI) of the composite outcome was 1.6 (1.6,1.7) in TED and 1.6 (1.6,1.6) in GD compared to GP. Key predictors included baseline diabetes, age, TED, GD, overweight/obesity and statin use. Conclusion: Comorbid diabetes was more common in patients with TED or GD than in GP. TED and GD were each independently associated with a 60% increased risk of hyperglycemia and diabetes-related complications compared to GP. These findings emphasize the need for proactive metabolic monitoring and integrated multidisciplinary care to reduce cardiometabolic risk in patients with TED. Presentation: Monday, July 14, 2025