2708-LB: Integrated Cardiovascular Risk Assessment in Young Adults with Type 2 Diabetes: The “YOUNG DIABETES” Program

Introduction and Objective: Early-onset type 2 diabetes (T2D) is associated with a more adverse cardiometabolic profile and increased cardiovascular (CV) risk. We aimed to characterize cardiovascular risk and subclinical atherosclerosis in young adults with T2D participating in the YOUNG DIABETES program. Methods: Observational study including individuals with T2D diagnosed at ≤50 years and current age ≤55 years enrolled in the YOUNG DIABETES clinical program. Participants underwent clinical and biochemical assessment, CV risk estimation (SCORE2-Diabetes), and carotid ultrasound to detect subclinical atherosclerosis. Results: A total of 179 participants were included; 37% were women. Median age was 45 years [37-50] and diabetes duration 4 years [1-10]. Active smoking was present in 18% and 25% were former smokers. Median BMI was 30.1 kg/m² [26.5-34.3], HbA1c 7.2% [6.4-8.6], LDL-C 101 mg/dL [86-125.3], and calculated CV risk by SCORE2-Diabetes 5.2% [3.9-7]. Carotid ultrasound was performed in 115 participants and identified subclinical atherosclerosis in 31% (20% had 1-2 plaques and 11% ≥3 plaques). Individuals with atherosclerosis were older (49 vs 42.5 years-old, p=0.0001), had longer diabetes duration (8 vs 2.5 years, p=0.0007), and higher HbA1c (7.9 vs 7%, p=0.03), No differences were observed by sex, smoking status, BMI, lipid profile, or calculated CV risk. In multivariate analysis, diabetes duration (OR 1.09 [1.01-1.17] and smoking exposure (OR 1.04 [1.00-1.07]) were independently associated with greater plaque burden. Conclusion: In young adults with T2D, in which SCORE2-Diabetes may underestimate cardiovascular risk, the YOUNG DIABETES program enables comprehensive cardiovascular risk stratification including detection of subclinical atherosclerosis. Carotid plaques were independently associated with longer diabetes duration and smoking exposure, highlighting the importance of early and strict glycemic control and smoking avoidance to reduce cardiovascular risk in young-onset T2D. Disclosure M. Mateu-Salat: Speaker's Bureau; Ended; Novo Nordisk, Daiichi Sankyo, Sanofi. A. Blanco-Carrasco: Speaker's Bureau; Current; Lilly, Novo Nordisk, AstraZeneca, Sanofi, Menarini Group. A. Atzeni: None. M.B. Caballero: None. A. Azketa: None. A. Jiménez Pineda: Other - Conference fees; Ended; Novo Nordisk Canada Inc., Lilly, Daiichi Sankyo. C. Viñals: None. M. Gimenez Alvarez: Speaker's Bureau; Ended; AstraZeneca. Advisory Panel; Current; Abbott Diabetes. Speaker's Bureau; Ended; Lilly Diabetes, Sanofi-Aventis U.S. Advisory Panel; Current; Medtronic.