2381-P: International Comparison of Adjuvant Pharmacotherapy Use in Type 1 Diabetes 2018–2024

Introduction and Objective: Since the latest report of the T1D Exchange (T1DX) and Prospective Diabetes Follow-up (DPV) registries on adjuvant pharmacotherapy use in type 1 diabetes (T1D) a decade ago, more medications for management of type 2 diabetes (T2D) have been approved that may also be beneficial for T1D. This study evaluated the use of T2D-approved agents as adjunctive therapy in T1D since 2018 in the T1DX and DPV registries. Methods: Both registries separately analyzed adjuvant mediation use by class (metformin, GLP-1 RA, SGLT2i, DPP-4i), stratified by year (2018-2024) and by age range (18 y, 18-40 y, 40-65 y, ≥65 y). Results: In the T1DX, adjuvant medication use increased from 2.1% in 2018 to 5.6% in 2024, whereas in the DPV, utilization peaked at 2.2% in 2021. In both registries, the highest rates of any co-medication were observed in those ≥40 y (Figure 1a). While GLP-1 RA surpassed metformin in the T1DX in 2023, metformin remained most common in the DPV with SLGT-2i peaking in 2021 (Figure 1b). Conclusion: Use of any adjuvant pharmacotherapy for T1D was infrequent in both registries, although the rate has been increasing recently in the T1DX, especially for GLP-1 RA. SLGT-2i peak in the DPV coincided with a temporary regulatory approval for T1D in Europe. Given potential benefits of GLP-1 RA and SGLT2i for glycemic control, weight management, and cardiovascular health, more evidence is needed for a broader use of these medications in T1D. Disclosure S. Lyons: None. J. Seufert: Advisory Panel; Current; Boehringer Ingelheim International GmbH. Research Support; Current; Boehringer Ingelheim International GmbH. Speaker's Bureau; Current; Boehringer Ingelheim International GmbH, AstraZeneca. Research Support; Current; AstraZeneca. Advisory Panel; Current; Sanofi, Lilly. Speaker's Bureau; Current; Lilly, GlaxoSmithKline plc., Novo Nordisk. S. Rompicherla: None. J.K. Mader: Research Support; Current; A. Menarini Diagnostics. Advisory Panel; Current; Abbott Diabetes. Speaker's Bureau; Current; Abbott Diabetes. Advisory Panel; Current; Becton, Dickinson and Company. Speaker's Bureau; Current; Becton, Dickinson and Company. Advisory Panel; Current; Insulet Corporation, Eli Lilly and Company. Speaker's Bureau; Current; Eli Lilly and Company. Advisory Panel; Current; Sanofi. Speaker's Bureau; Current; Sanofi. Advisory Panel; Current; Novo Nordisk A/S. Speaker's Bureau; Current; Novo Nordisk A/S. Advisory Panel; Current; Roche Diagnostics. Speaker's Bureau; Current; Roche Diagnostics. Advisory Panel; Current; Medtronic, Tandem Diabetes Care, Inc., Omnipod. Stock/Shareholder; Current; decide Clinical Software GmbH. Advisory Panel; Current; Dexcom, Inc. Speaker's Bureau; Current; Dexcom, Inc., Sinocare, Buzud. Advisory Panel; Current; Biomea Fusion, Pharmasens. Stock/Shareholder; Current; elyte Diagnostics. Other - CMO (unpaid); Current; elyte Diagnostics. Speaker's Bureau; Current; A. Menarini Diagnostics. Board Member; Current; OMNIA by AI APS. Advisory Panel; Current; Triple Jump. S. Thapa: None. D. Maahs: Advisory Panel; Current; Abbott Diabetes, Sanofi, Medtronic, biospex, enable biosciences, kriya. A. Müller: Board Member; Current; Sanofi-Aventis Deutschland GmbH. Speaker's Bureau; Current; Sanofi-Aventis Deutschland GmbH. J.C. Wong: Research Support; Ended; Abbott Diabetes. C. Reinauer: None. N. Mathioudakis: None. S. Lanzinger: None.