2244-P: Change in Diabetes Health System Performance in Nine Countries

Introduction and Objective: The WHO has established global diabetes coverage targets for people with diabetes. We compare changes in diabetes health system performance over time in 8 countries compared to the US. Methods: We use the Global Health and Population Project on Access to Care for Cardiometabolic Disease (HPACC) to estimate country-level changes in WHO targets over time: proportion diagnosed among people with diabetes (HbA1c ≥ 6.5% or treated), and among the diagnosed, glycaemic control (HbA1c < 8%), blood pressure (BP) control (systolic BP < 140 mmHg and diastolic BP < 90 mmHg), and statin use in those ≥ 40 years old. Eligible countries had 2 surveys no more than 10 years apart. We also report outcomes by proportion of GDP spent on health. Results: Our analysis includes Bhutan, Burkina Faso, Costa Rica, Malawi, Mexico, Mongolia, Sri Lanka, the US, and Vietnam (n = 218,244). Between 2010-2021, diabetes diagnosis and glycaemic control declined in 5 of 9 (56%) countries. In contrast, hypertension improved in 7 of 9 (78%). Among the 6 countries reporting on statin use, half (3) experienced an increase. We plot changes in country target performance (Figure 1). Conclusion: The differences in performance over time, especially mixed results in glycemic control and statin use, underscore unique opportunities to improve diabetes outcomes. Despite higher health spending, the US slightly worsened in glycemic control but improved in statin use. Conversely, Mexico and Bhutan saw improvements across all targets with lower spending. Disclosure M.W. Lam: None. M. Theilmann: None. M. Marcus: None. D. Flood: None. A.S. Wu: None. M.A. Sulola: None. J. Giardina: None. E.P. Hyle: None. O. Bello-Chavolla: None. M.K. Ali: Consultant; Ended; Eli Lilly and Company, Siemens, Novo Nordisk. J. Manne-Goehler: None. Funding National Institutes of Health (R01HL172907)