2190-P: Socioeconomic Inequalities in Achieving WHO Global Diabetes Targets in India, Mexico, and South Africa

Introduction and Objective: Among 560 million people with diabetes globally, 80% live in low- and middle-income countries where substantial gaps in care persist. We assessed progress toward the WHO Global Diabetes Compact targets across socioeconomic groups in three geographically diverse countries (India, Mexico, and South Africa). Methods: We analyzed data on adults aged 20-49 years from nationally representative surveys (India: NFHS 2019-2021, N=806,449; Mexico: ENSANUT 2018-2019, N=13,162; South Africa: DHS 2016, N=26,095). We evaluated progress towards four WHO targets among individuals with diabetes: (1) ≥80% diagnosed; among those diagnosed: (2) ≥80% glycemic control, (3) ≥80% BP control; and if ≥ 40 years old: (4) ≥60% on statins. Weighted logistic regressions examined associations with household wealth (asset index), adjusting for age and sex. Results: No country achieved the WHO targets, although Mexico reached 83% BP control among the diagnosed (Goal 3). Household wealth was not significantly associated with target achievement in any country (Figure 1). Only in India, diabetes diagnosis was higher among individuals in the highest compared to the lowest wealth tertile (predicted probabilities: 60.5% [57.2 - 63.9] vs. 45.3% [40.1 - 50.6]). Conclusion: These results highlight universal health system challenges in diabetes care delivery across India, Mexico, and South Africa. Disclosure A. Rust: None. M. Theilmann: None. M.W. Lam: None. M. Marcus: None. D. Flood: None. A.S. Wu: None. M.A. Sulola: None. J. Giardina: None. E.P. Hyle: None. N. Tandon: None. O. Bello-Chavolla: None. M.K. Ali: Consultant; Ended; Eli Lilly and Company, Siemens, Novo Nordisk. J. Manne-Goehler: None. Funding NHLBI (1R01HL172907-01A1)