172-LB: Early-Onset Type 2 Diabetes Is Associated with Higher A1C and Glycemic Variability in a Cohort of Veterans followed Prospectively

Introduction: Early-onset type 2 diabetes in adults (eoT2D; T2D diagnosed between 18 and 39 years) is increasingly prevalent and is associated with high rates of diabetic complications. We hypothesized that eoT2D would be associated with adverse glycemic parameters (e.g., higher A1c and glycemic variability) . Methods: We used data from the Veterans Administration Diabetes Risk Cohort, a dynamic cohort of all U.S. Veterans enrolled in the Veterans Health Administration since 1/1/08 who were free from diabetes at enrollment. Among participants who developed T2D (n=936,596) , we fit linear regression models examining associations of age at detection with A1c-based measures of glycemia. Results: A ten-year younger age at detection was associated with a 0.24% higher A1c at T2D detection, a 0.29% higher mean A1c, a 0.02% higher A1c coefficient of variation (CV) , and a 0.02% higher A1c average real variability (ARV) . Compared to T2D with onset after 40 years, eoT2D was associated with a 0.73% higher A1c at T2D detection, a 0.82% higher mean A1c, a 0.05% higher CV, and a 0.04% higher ARV (all p<0.0001, Table 1) . Conclusions: eoT2D is associated with higher A1c and glycemic variability. Further study of glycemic trajectories, modifiable risk factors, and clinical course in this T2D subgroup are needed. Disclosure S. Avramovic: None. M. D. Schwartz: None. D. Enquobahrie: None. E. J. Boyko: None. P. Wander: None.