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700-P: Treatment of New-Onset Type 2 Diabetes after Age 65: A Longitudinal Cohort Study

As the U.S. population ages, more older adults will be newly diagnosed with type 2 diabetes (T2D). These individuals have a greater prevalence of comorbidities placing them at increased risk for T2D-related adverse drug events. We identified adults ≥ 65 within an integrated care system with newly diagnosed T2D, defined by a first elevated A1c (≥6.5%) with no evidence of T2D prior 18 months. We examined treatment initiation (metformin, sulfonylurea [SFU], insulin) during the 5 years following diagnosis among patients with 3 treatment-sensitive comorbid conditions (chronic kidney disease [CKD], dementia, frailty) at time of diagnosis. We compared A1c levels between treatment initiators vs. non-initiators and identified independent predictors of treatment initiation using multivariate logistic models. The 4,011 older adults with new T2D had mean age 72.2 ± 6.4 years, 53% were women, 50% were non-Hispanic white. Among those with advanced CKD (≥ stage 3b, 4% of cohort), nearly one-quarter (23%) were initiated on metformin (mean A1C 8.3 ± 2.7 vs. untreated 7.3 ± 1.4 p Disclosure P. Mishra: None. A. Gopalan: None. R.W. Grant: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases