2264-P: Impact of Baseline Glycemic Control on the Development of Diabetes-Related Complications in 111,519 Newly Diagnosed Type 2 Diabetes Patients: An 11-Year Longitudinal Analysis (2014–2025)

Introduction and Objective: Early metabolic control is a critical determinant of long-term prognosis in T2D. The objective of this study was to evaluate the association between baseline HbA1c and the risk of developing a first diabetes-related complication over 11 years of follow-up of newly diagnosed T2D patients in PHC units from Mexico. Methods: We conducted a retrospective longitudinal cohort study using the national Chronic Disease Information System (SIC). The analysis included information of 111,519 newly diagnosed T2D patients from 2014 to 2025 who were free of diabetes-related complications at diagnosis. Complication-free survival was estimated using Kaplan-Meier curves with log-rank testing. A Cox proportional hazards model was used to identify independent predictors. Results: During follow-up, 3,407 patients developed a first diabetes-related complication. The most common were neuropathy (37.1%), CKD (9.8%), and CVD (9.1%). Survival analysis demonstrated that patients with baseline HbA1c ≥12% have a drastically increased probability of developing diabetes-related complications (p < 0.001), with over 25% experiencing one by year 11. In the adjusted model (n=43,320), baseline HbA1c ≥12% was associated with a 34% higher risk (p = 0.001), meanwhile age was a dominant driver with patients aged 45-59 years facing a 50% higher risk (p = 0.047), escalating to an 88% increase for those ≥75 years (p = 0.006). Conclusion: Patients with HbA1c ≥12% at diagnosis exhibit and accelerated development of diabetes-related complications, particularly neuropathy. These findings highlight an area of opportunity at diagnosis for aggressive glycemic management, especially among middle-aged and older adults, to reduce the long-term burden of diabetes-related complications in PHC units from Mexico. Disclosure A.A. Montoya: None. G. Martinez-Silva: None. D. Alvarez-Hernandez: None. R. Garcia-Cerde: None. R. Saucedo-Martinez: None. H.J. Gallardo-Rincon: None. R. Mujica-Rosales: None. R. Tapia-Conyer: None.