423-P: Racial and Ethnic Disparities in Mortality and Cardiovascular Disease in Patients with Type 2 Diabetes in a U.S. Integrated Health-Care System

Previous research has documented higher mortality rates and risk of diabetes complications in ethnic minorities in the U.S. While genetic predisposition and lifestyle are potential important factors associated with this disparity, the role of access to care has not been well studied. We examined all-cause mortality and incidence of cardiovascular disease (CVD) by race/ethnicity in a type 2 diabetes (T2DM) population within in a large U.S. integrated healthcare system. We identified adult patients with incident T2DM between 1/1/2003-12/31/2014 using electronic health record (EHR) data and followed them through 6/30/2018. Patient demographics, CVD risk factors, medical history, and medication use were ascertained from the EHR. Age- and sex-adjusted all-cause mortality and incidence rates of myocardial infarction (MI) and heart failure (HF) were estimated by race/ethnicity. Hazard ratios were estimated using multivariable Cox proportional hazards models. We identified 135,199 patients with incident T2DM (mean±SD age: 58±13 years, 48% female, and median follow-up 6 years). 36% were white, 35% Hispanic, 12% Asian, and 12% black. All-cause mortality and incidence of MI and HF were highest among whites followed by blacks (Table). These findings suggest that improving access to quality care may help reduce racial/ethnic health disparities among patients with T2DM. Disclosure J. An: Research Support; Self; Merck & Co., Inc. G.A. Nichols: Research Support; Self; Amarin Corporation, Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Scientific Affairs, LLC., Merck Sharp & Dohme Corp. L. Qian: None. R. Wei: None. T. Harrison: None. M.A. Munis: None. Z. Li: None. T. Weiss: Employee; Self; Merck & Co., Inc. K. Iglay: Employee; Self; Merck & Co., Inc. Stock/Shareholder; Self; Merck & Co., Inc. S. Rajpathak: None. K. Reynolds: Research Support; Self; Amarin Corporation, Amgen Inc., Merck Sharp & Dohme Corp., Novartis AG.