6-PUB: Prevention of Severe Lower Extremity Artery Disease in Patients with Diabetes—Analysis of Factors Using a Large Database

Lower extremity artery disease (LEAD) leading to comprehensive chronic lower limb ischemia has been reported to increase the risk of lower limb amputation and death from macrovascular disease in patients with type 1 diabetes(T1D) and type 2 diabetes(T2D). Due to the lack of large-scale studies on LEAD in Asians with diabetes, we investigated factors that may reduce LEAD severity. This cross-sectional study was performed using data from the Medical Data Vision administrative claims database. Wound care was defined as the severity of LEAD. Factors associated with reducing the severity of LEAD was analyzed using logistic analysis with the presence of wound care as the objective variable and patient background, presence and frequency of diabetes educational hospitalization, and concomitant medications as explanatory variables. The study population consisted of 282,353 patients with LEAD disease. Wound care was performed on 32,978 patients (5.4%). Multivariate analysis was performed, and the results were as follows: once (OR: 0.26), twice (OR: 12.6), three or more times (OR: 8.3) with no diabetes education hospitalization as the reference. As <65 years of age as reference, patients aged 65-74 years (OR: 0.60), ≥75 years (OR: 0.38), and T1D as reference, T2D (OR: 1.68). SUs, metformin, SGLT2is, GLP-1s, DPP-4is, CCBs, angiotensin receptor-neprilysin inhibitors, statins, and fibrates significantly reduced OR. This study also allowed us to identify patient backgrounds predisposed to LEAD severity and medications that may reduce severity of LEAD. In addition to the implementation of educational hospitalization, this study will help in the selection of drugs to reduce the severity of LEAD.