UC Irvine

Atherosclerotic Cardiovascular Disease (ASCVD) remains the leading cause of death in diabetes mellitus (DM) adult patients. I investigated the current status of ASCVD and DM risk factor control for DM adult patients in the UCI health system, stratified by sex, race/ethnicity, and ASCVD status, A total of 34,207 DM adult patients were identified in the UCI electronic health records (EHR) through ICD-10 code during the timeframe of January 1st, 2022 – June 30th, 2023. Of these patients, within a year after their last DM diagnosis, while 91.3% received a blood pressure (BP) measurement, only 55.3% received a hemoglobin A1c (HbA1c) measurement and less than 50% received any kind of lipid profile measurement (total cholesterol, HDL-C, LDL-C, and triglycerides). Only 56.5% of patients were on any kind of DM drugs, with just 34.1% on metformin, even lower (29.6%) for patients with ASCVD. Only 15.6 % and 10.7% were on newer DM therapies of SGLT2i and GLP1-RA drugs, respectively. Only 46.6% were on statins, and non-statin use was infrequent (<3%). Statin usage was much higher in DM patients with ASCVD (72.5%) than those without (38.7%). 84.6% of DM patients reached control for BP. 94.0% of DM patients with ASCVD reached target control for BP, which was significantly higher compared to 81.6% for DM patients without ASCVD (p<0.00001). However, only 48.9% were at target control for HbA1c, 23.0% for LDL-C and 10.1% for composite control (HbA1c + BP + LDL-C). Some of these findings differed by race/ethnicity, such as only 36.4% of Hispanic patients being at target control for HbA1c, compared to 48.9% for the overall sample. A substantial number of DM patients in the UCI EHR are not receiving recommended risk factor measurements and treatment. Improving the frequency of yearly testing and drug therapies in these patients could prove invaluable in optimizing care in DM patients.