Visual Abstract

Although early pharmacotherapy is recommended for type 2 diabetes (T2DM), the effectiveness of early treatment in Chinese adults is understudied. Chinese populations have a different pattern of complications to Western populations.

We analysed a cohort of Chinese adults with T2DM from 2007 to 2017 in the Hong Kong public health care system. Early and delayed groups was defined as pharmacotherapy within 3 months and 3-12 months after T2DM diagnosis respectively. We fitted Cox proportional hazard models on 3122 pairs of propensity-score matched participants to assess treatment intensification with insulin, all-cause mortality, and complications (myocardial infarction, ischemic heart disease, stroke, heart failure, peripheral vascular disease, neuropathy, amputation, skin ulcer, renal failure, retinopathy, cataracts). We accounted for immortality bias by beginning follow-up at the end of the exposure window (12m post-diagnosis).

Early pharmacotherapy was associated with reduced risk of treatment intensification with insulin (HR: 0.758; 95% CI: 0.584-0.984). This finding was consistent using alternative thresholds for early treatment (3m intervals from 0-9 months) and for metformin monotherapy. No statistically significant difference for other clinical outcomes were observed. Longer follow-up and larger sample size are required to evaluate other clinical outcomes.

Disclosure

Y. Lau: None. Y. Yuen: None. C. Ng: None. J. Quan: None.

Funding

Research Grants Council of Hong Kong (27112518)

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