783-P: Efficacy of GLP-1RA according to Type 2 Diabetes Phenotypes—A Monocentric Retrospective Study

Introduction MOD, mild obesity-related diabetes; SIDD, severe insulin deficient diabetes; SIRD, severe insulin resistant diabetes) was performed via the algorithm developed by Bello-Chavolla et al. (BMJ, 2020). The primary outcome was difference in HbA1c change from baseline, evaluated with ANOVA. SHapley Additive exPlanations (SHAP) allowed to rank predictors of HbA1c reduction. Kaplan-Meier analysis and log-rank test were used to estimate differences in time to treatment failure, defined as time to HbA1c ≥7.0%. Results: We enrolled 128 patients. The SIDD phenotype was associated with a significantly greater HbA1c reduction (-1.9% vs. -0.67% MARD, -0.75% MOD, -0.56% SIRD; p0.001) following GLP-1RA initiation after a median follow-up of 8 months. However, SHAP analysis identified baseline HbA1c, rather than SIDD phenotype, as the most relevant predictor of HbA1c change, accounting for ~0.5% HbA1c reduction. Yet, belonging to the SIDD phenotype was associated to earlier treatment failure (p0.01). Conclusion: Easily available clinical variables such as baseline HbA1c might be more useful to predict response to GLP-1RA than T2D subclassification. However, the diverse pathogenesis of T2D phenotypes might account for differences in treatment durability. Disclosure I. Caruso: Other Relationship; Eli Lilly and Company, Novo Nordisk, Laboratori Guidotti SpA. F. Giordano: None. L. Di Gioia: Consultant; Roche Diabetes Care, Eli Lilly and Company, Novo Nordisk, Sanofi. I.I. Matichecchia: None. A. Cignarelli: None. G. Sorice: None. S. Perrini: None. A. Natalicchio: Speaker's Bureau; AstraZeneca, Novo Nordisk, Sanofi, Eli Lilly and Company. L. Laviola: Speaker's Bureau; A. Menarini Diagnostics, Abbott, AlfaSigma. Advisory Panel; Boehringer-Ingelheim, Eli Lilly and Company, Medtronic, Novo Nordisk. Speaker's Bureau; AstraZeneca. Advisory Panel; Roche Diabetes Care, Sanofi. Speaker's Bureau; Terumo Corporation. F. Giorgino: Consultant; AstraZeneca, Boehringer-Ingelheim, Eli Lilly and Company, LifeScan Diabetes Institute, Merck Sharp Eli Lilly and Company, Roche Diabetes Care.