2042-P: Disparities in Diabetes Medication Use among Hispanic Adults with Type 2 Diabetes Mellitus

Introduction and Objective: Hispanic adults experience a disproportionate burden of type 2 diabetes mellitus (T2DM). This study examined ethnic differences in antidiabetic medication prescribing, medication adherence, and their associations with hemoglobin A1c (HbA1c) control. Methods: We analyzed electronic health record data from the University of California Data Warehouse. Adults with T2DM (ICD-10: E11), a baseline HbA1c ≥7% between 2019 and 2023, and a follow-up HbA1c at least 6 months later were included. Medication adherence was defined as the proportion of days covered between HbA1c measurements and categorized as good (≥80%) or poor (<80%). Paired t-tests were used to assess HbA1c changes by prescription pattern and adherence status. Results: Among 28,066 patients (mean age 62.8 ± 13.1 years; 44.4% female), 27.7% identified as Hispanic. Hispanic patients had higher baseline HbA1c compared with non-Hispanic patients (9.3 ± 2.1% vs. 8.7 ± 1.8%). Following the index HbA1c, 21.1% vs. 22.3% received no antidiabetic therapy, 21.7% vs. 16.8% initiated treatment, 36.4% vs. 38.3% remained on prior therapy, 19.1% vs. 21.0% switched to newer agents (GLP-1 RA or SGLT2i), and 1.6% vs.1.7% discontinued therapy in Hispanic vs. non Hispanic patients. Hispanic patients who initiated or intensified therapy experienced greater HbA1c reductions than non-Hispanic White patients (p < 0.05). Medication adherence was lower among Hispanic patients (82.2% vs. 89.8%), yet among adherent patients, HbA1c reductions were greater in Hispanic patients (−0.9 vs. −0.7; p < 0.0001). Conclusion: Targeted multilevel interventions addressing both prescribing practices and medication adherence are needed to improve glycemic outcomes and reduce disparities among Hispanic adults with T2DM. Disclosure W. Fan: None. Y. Fan: None. K. Yuan: None. Z. Wang: None. Q. Yang: None. A. Amin: Consultant; Ended; Pfizer Inc., Salix Pharmaceuticals, Novo Nordisk, AstraZeneca, Bayer AG, Ferring Pharmaceuticals, Gilead Sciences, Inc., Seres, Spero, Renibus, Reprieve, HeartRite, Alexion, GSK, Dexcom, Eli Lilly and Company. Consultant; Current; Aseptiscope. N. Wong: Research Support; Ended; Novo Nordisk. Research Support; Current; Amgen Inc. Funding Research funding provided by the UC Irvine Diabetes Center