253-OR: Statin Prescriptions for Prevention of Atherosclerotic Cardiovascular Disease in Adults 40–75 Years Old with Type 1 Diabetes
Abstract
Introduction and Objective: Guidelines recommend statins for prevention of ASCVD in adults 40-75 yrs old with diabetes. This study of real-world statin use in T1D investigates prescribing practices, disparities, and barriers.
Methods: A retrospective cross-sectional study was performed in adults 40-75 yrs old with T1D who established with endocrinology (endo) at a large academic center from 2015-2018. Charts were reviewed for prescriptions as of December 2024.
Results: We included 266 patients: 55.3% female (N=147), 80.8% (N=215) white, aged 54.4 ± 10.0 yrs with A1c 7.8 ± 1.6%. There were 21.1% (N=56) with prior ASCVD, of which 39.3% (N=22) were on high intensity statin. For primary prevention, 44.3% (N=93/210) were on moderate or high intensity statin. Overall, only 43.2% (N=115) were on guideline-directed statin intensity. Patients prescribed statin by endo (N=56) vs PCP/other provider (N=86) were more often on the recommended intensity (91.1% vs 74.4%, p=0.013). From endo notes, the main reason for statin under-treatment was deference to PCP/other provider in 23.3% (N=62), followed by intolerance in 15.8% (N=42). Women were less likely to get guideline-recommended statin (36.7% vs 51.3%, p=0.017). Endos were more likely to defer to other providers for statins in women (28.6% vs 16.8%, p=0.024) and there was a nonsignificant difference in statin intolerance by gender (18.4% vs 11.7%, p=0.138). Other LDL-lowering agents were rarely used: ezetimibe 4.1% (N=11),…
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