1311-OR: Achieving at Least 15% Weight Loss within 2 Years of T2D Diagnosis Is Associated with a Lower Long-Term Risk of Micro- and Macrovascular Disease: A UK Cohort Study

Introduction and Objective: Real-world studies estimating the impact of substantial weight loss (WL) on vascular events in T2D are scarce. This retrospective cohort study investigated micro- and macrovascular risk after ≥15% WL in adults with newly diagnosed T2D. Methods: Adults with T2D and obesity were identified in UK primary care data from Clinical Practice Research Datalink (CPRD) from Jan 2000. Those achieving ≥15% WL were propensity score (PS) matched 1:4 to controls with <2% weight change. The PS included potential confounders, e.g. T2D date, age, sex, ethnicity, deprivation index, BMI, HbA1c, smoking, T2D medication, and comorbidities. Cumulative incidences were described, and time to micro- and macrovascular events was estimated using Cox proportional hazards models. Results: The matched cohort included 13,658 individuals with ≥15% WL and 54,632 controls. The risk of micro- (A) and macrovascular (B) events was 13% (HR 0.87, CI95% 0.82;0.91) and 10% (HR 0.90, CI95% 0.84;0.95) lower in the WL group vs controls, respectively. The proportion of individuals reaching HbA1c targets of ≤6.5% and <5.7% was substantially greater in the WL group vs controls (C-D). Conclusion: In a real-world setting, ≥15% WL within 2 years of T2D diagnosis was associated with a lower risk of micro- and macrovascular events and better glycemic control compared with stable weight. These data further support early WL interventions in T2D management. Disclosure N. Sattar: Advisory Panel; Ended; AbbVie Inc. Consultant; Current; Amgen Inc. Advisory Panel; Current; AstraZeneca. Research Support; Current; AstraZeneca. Consultant; Current; Boehringer Ingelheim International GmbH. Research Support; Current; Boehringer Ingelheim International GmbH. Other - Advisory, Consultant and Speaker Honoraria; Current; Eli Lilly and Company. Consultant; Current; Gan & Lee Pharmaceuticals, GlaxoSmithKline plc. Advisory Panel; Ended; Hanmi Pharm. Co., Ltd. Advisory Panel; Current; Kailera. Consultant; Current; Mass Medicines, Menarini Group, Metsera. Other - Advisory, Consultant and Speaker Honoraria; Current; Novo Nordisk. Consultant; Current; Pfizer Inc. Other - Advisory and Consultant; Current; Roche Pharmaceuticals. Other - Speaker Honoraria; Ended; UCB Pharma. Advisory Panel; Current; Verdiva Bio. Advisory Panel; Ended; Regeneron Pharmaceuticals Inc. Consultant; Ended; Carmot Therapeutics, Inc. J. Bengtsson: Employee; Current; Novo Nordisk A/S. Stock/Shareholder; Current; Novo Nordisk A/S. T. Halasa: Employee; Current; Novo Nordisk A/S. Stock/Shareholder; Current; Novo Nordisk A/S. A. Lotfi: Employee; Current; Novo Nordisk A/S. Stock/Shareholder; Current; Novo Nordisk A/S, Eli Lilly and Company. C.P. Miller: Employee; Current; Novo Nordisk A/S. Stock/Shareholder; Current; Novo Nordisk A/S. E. Johnsen: Employee; Current; Novo Nordisk A/S. Funding Novo Nordisk A/S