SAT-604 Use of Adjunctive Therapy in Patients With Autoimmune Diabetes In the Renaced DT1 Registry

Abstract Disclosure: A.L. Garcia Tuomola: None. P. Almeda-Valdes: None. N.E. Antonio Villa: None. M. Vidrio Velazquez: None. N.E. De la Garza: None. G. Gonzalez-Galvez: None. J.F. Bustamante: None. A. Yepez: None. S. Miracle-Lopez: None. L. Islas-Ortega: None. K.L. Sanchez-Ruiz: None. C. Castillo: None. M. Valadez-Capetillo: None. J. Ceballos: None. E. Rodriguez-Sanchez: None. R.S. Niño-Vargas: None. R.N. Faradji: None. The treatment of autoimmune diabetes - type 1 (T1D) and latent autoimmune diabetes of the adult (LADA), has improved greatly due to novel insulins, methods of administration, continuous glucose monitoring and automated insulin delivery (AID) systems. However, a large proportion of patients do not reach glycemic goals. Additionally, new technology affordability and availability is limited in low-income settings. Treatment should aim for more effective weight management and reduction of cardiovascular risk. These goals are not always achieved with insulin alone and might be addressed with adjunctive agents. Objective: To describe the sociodemographic characteristics, metabolic control, complications and cardiovascular risk, in patients with autoimmune diabetes receiving insulin plus adjunct therapies (IAT) versus insulin only (IO) registered in the National Registry of patients with Type 1 Diabetes (RENACED-DT1) in Mexico. Methodology: Anthropometric variables, metabolic control, insulin dosage, acute and chronic complications were compared between patients receiving IO vs IAT. Results: Of the 1579 patients registered (1435 T1D, 144 LADA), 1190 (75.3%) were treated with IO and 389 (23.1%) were treated with IAT. From the group of IAT users 74% (289) had T1D diagnosis and 26% (100) had LADA. The most common used add on medications were: metformin (78%), SGLT2 (30%), DPP4 inhibitors (17%), GLP-1 agonists (9%), thiazolidinediones (3%) and alpha-glucosidase inhibitors (0.3%). BMI was higher in patients in the IAT vs IO groups (25.7 vs 23.1 kg/m2). Differences in HbA1c were observed (8.3% in IO vs 8.1% in the IAT groups p<0.05). No differences were found related to the incidence of hypoglycemia or diabetic ketoacidosis. A higher prevalence of diabetic neuropathy (18% IAT vs 12% IO p=0.001), retinopathy (25% IAT vs 17% IO, p=0.001) and nephropathy (18% IAT vs 13% IO) were found in patients from the IAT vs IO group. Individuals in the IAT group were older than those in the IO group (30 vs 24 years, p=0.001) and had longer diabetes duration (12 years IAT vs 10 years in IO p=0.001). Patients in the IAT group used lower insulin doses compared with patients from the IO group (0.57 U/kg/day vs 0.64 U/kg/day, p<0.001). A higher number of patients with LADA diagnosis used IAT compared with patients with T1D (69% vs 20%). Conclusions: A significant number of patients with autoimmune diabetes from the Mexican RENACED-DT1 Registry are treated with adjunctive therapy. Metformin is the most commonly add on therapy. The IAT group showed higher incidence of chronic complications and BMI, but this is probably because these complications prompted the use of these therapies to improve them. The most significant difference in the IAT appears to be lower daily insulin requirements. In countries with limited affordability, reduction of insulin dose as a result of add on therapies may prove helpful to treatment adherence. Presentation: Saturday, July 12, 2025