1353-P: Comparing Health Outcomes among People with Type 1 Diabetes in Europe and the United States
Authors: CHANEN SYDNEY , BELTRAN ALAN , ZENG ALISON , BELL TREVOR , WOOD RICHARD 
Published: June 2024

Although people with Type 1 diabetes (PWT1) in Europe (EU) and the United States (US) have similar access to diabetes technologies, many factors impacting diabetes management - such as the nutritional landscape, as well as the cost and availability of healthcare - differ across these regions. This study aimed to compare health outcomes for PWT1 on the same treatment regimens between the EU and the US.
From Mar. - Nov. 2023, PWT1 in the US, France, Germany, Italy, the Netherlands, Sweden, and the United Kingdom took online surveys in which they self-reported their insulin delivery method, height, weight, A1c, and diabetes-related health complications (ranging from high blood pressure to sleep problems). Emotional well-being was assessed using the WHO-5 Well-Being Index. Children and respondents who have been diagnosed with diabetes for less than two years were excluded.
Overall, significantly more PWT1 in the US (n=2,238) experience obesity (BMI ≥ 30) (28% vs. 25%, p&lt;0.05), while significantly more PWT1 in the EU (n=2,095) reported an A1c &gt; 7 (42% vs. 27%, p&lt;0.01). Further, automated insulin delivery system (AID) users in the EU (n=729) experience significantly higher rates of poor well-being (WHO-5 score &lt;13) compared to AID users in the US (n=1,551) (40% vs. 28%, p&lt;0.01). Regardless of therapy type (AID vs. multiple daily injections), PWT1 in the US experience significantly higher rates of high cholesterol (22% vs. 14%, p&lt;0.01), high blood pressure (25% vs. 17%, p&lt;0.01), nerve damage (13% vs. 8%, p&lt;0.01), and gastrointestinal issues (15% vs. 8%, p&lt;0.01) compared to the EU.
This research emphasizes the prevalence of obesity and its related complications in the US. Further research is needed to identify and solve the drivers of elevated A1c and the mental health burden facing PWT1 in the EU. Beyond developing new diabetes technologies, both regions must focus on improving non-medical determinants of health - such as diet, exercise, and mental healthcare - to achieve health parity for PWT1 across the world.

Disclosure
S. Chanen: Research Support; Abbott, Dexcom, Inc., Eli Lilly and Company, diaTribe, Insulet Corporation, Medtronic, Roche Diabetes Care, Tandem Diabetes Care, Inc., Ypsomed AG, Teladoc Health. A. Beltran: Research Support; Abbott, Dexcom, Inc., Eli Lilly and Company, diaTribe, Insulet Corporation, Medtronic, Roche Diabetes Care, Tandem Diabetes Care, Inc., Ypsomed AG, Teladoc Health. A. Zeng: Employee; dQ&A. Research Support; Abbott, Dexcom, Inc., Eli Lilly and Company, diaTribe, Insulet Corporation, Medtronic, Roche Diabetes Care, Tandem Diabetes Care, Inc., Ypsomed AG, Teladoc Health. T. Bell: Research Support; Abbott, Dexcom, Inc., Eli Lilly and Company, diaTribe, Insulet Corporation, Medtronic, Roche Diabetes Care, Tandem Diabetes Care, Inc., Ypsomed AG, Teladoc Health. R. Wood: Research Support; Abbott, Dexcom, Inc., Eli Lilly and Company, diaTribe, Insulet Corporation, Medtronic, Roche Diabetes Care, Tandem Diabetes Care, Inc., Ypsomed AG, Teladoc Health.