1428-P: Impact of Socioeconomic Inequalities on COVID-19 Mortality of People Living with Diabetes during the 2020 Epidemic Waves in France

Introduction & Objective: The aim was to describe the impact of socioeconomic inequalities (SEI) on COVID-19 mortality in people living with pharmacologically treated diabetes (TD) during the two 2020 epidemic waves (W1: March-May; W2: September-December) in European France.

Methods: TD were identified using a validated algorithm from the French National Health Data System. COVID-19 mortality in 2020 was obtained from medical causes of death for people alive on January 1, 2020. SEI were measured using the French Deprivation index (FDep, by population quintiles; Q1: corresponding to the least deprived municipalities). Annual average age-standardized (European standard population 2013) mortality rates (aMR) for each wave are presented with their 95% confidence intervals [IC95%] per 100,000 person-years.

Results: During W1, the highest aMR were observed in men with TD living in the least deprived municipalities (Q1: 398 [373-422]). Then, the aMR decreased until Q3 (234 [219-249]) before increasing again until Q5 to 309 [297-321]. The same trends were observed but less pronounced in women with TD (Q1: 257 [240-275]; Q3: 156 [143-169] Q5: 196 [187-206]); and in men and women without TD. During W2, aMR were stable from Q1 to Q4, at around 240/100,000, and significantly higher in Q5: 300 [286-314] in men with TD. In women with TD, no difference was observed according to deprivation level (Q1: 171 [156-186] and Q5: 171 [162-180]), whereas an increasing gradient was observed in men and women without TD (respectively Q1: 45 [42-49]; Q5: 70 [66-74] and Q1: 17 [15-19]; Q5: 28 [25-30]).

Conclusion: These first descriptive results show that the impact of SEI on COVID-19 mortality appeared to change between the two epidemic waves in France in 2020. They raise questions about the impact of barrier measures and non-pharmaceutical interventions in SEI.