Adverse Clinical Outcomes Attributable to Socioeconomic and Ethnic Disparities among People with Impaired Glucose Tolerance in New Zealand over 25 Years

Aim: Future premature death and cardio-renal disease are common with impaired glucose tolerance (IGT). We aimed to quantify contributions of socioeconomic and ethnic disparities to outcomes in IGT in New Zealand (NZ). Methods: IGT enrolments 01/01/1994-31/07/2018 into the Diabetes Care Support Service (DCSS), an NZ primary care programme linked with national databases were followed up until death or 31/12/2019. Incident outcomes included premature mortality (PM), myocardial infarction (MI), stroke, heart failure (HF), and end-stage renal disease (ESRD). Attributable fraction (AF)s for the entire population and specific groups compared with the least deprived groups or NZ Europeans (NZE) were estimated with adjustment for covariates. Results: Among 26,031 people with IGT (mean age 57.2 years; 53.8% female), adjusted population AF to deprivation was significant for ESRD (18.90 (0.65-33.80)%) and to ethnicity was significant for MI (8.19 (0.18-15.56)%), stroke (10.33 (1.63-18.26)%), HF (12.15 (5.03-18.74)%) and ESRD (8.18 (0.65-33.80)%), respectively. Compared with NZE with the least socioeconomic deprivation, group-specific AF was higher in the most deprived NZE, Māori, and Pasifika for PM, stroke and ESRD; higher in more deprived NZE and Māori for MI and HF. Conclusions: Ethnic and socioeconomic disparities are responsible for a substantial proportion of adverse outcomes those with IGT. Disparities were common among Māori irrespective of socioeconomic status and NZE with the most socioeconomic deprivation. Preventative policies need to address both ethnic and socioeconomic disparities. Disclosure D.Yu: None. D.Simmons: Consultant; Sanofi, Speaker's Bureau; Abbott Diabetes. Dcss study group: n/a. J.Baker: None. R.G.Cutfield: Speaker's Bureau; Boehringer Ingelheim and Eli Lilly Alliance. K.A.Pickering: None. B.J.Orr-walker: None. U.L.Osuagwu: None. Y.Cai: None. Z.Wang: None. Z.Zhao: None.