Search

Glycemic change from baseline to 2-years was examined during the second year of LANDMARC, a 3-year prospective observational study (CTRI/2017/05/008452) , which included participants with T2D taking ≥2 antihyperglycemic medications (with/without glycemic control) . Out of 6234 evaluable participants (mean baseline values - age: 52.1 years, T2D duration: 8.59 years and A1C: 8.05%) , 5318 completed 2-year follow-up visit. All glycemic parameters improved significantly (p In conclusion, although there was a marked improvement in all the glycemic parameters from baseline, a large majority of the participants remained uncontrolled. This emphasizes the need for optimizing diabetes management in India. Disclosure S. Joshi: Advisory Panel; Abbott, Boehringer Ingelheim International GmbH, Dr. Reddy’s Laboratories Ltd., Eli Lilly and Company, Novo Nordisk, Roche Diabetes Care. Consultant; Biocon, Glenmark Pharmaceuticals, Sanofi, USV Private Limited. A.K. Das: Advisory Panel; Boehringer Ingelheim International GmbH, Novo Nordisk, Roche Diagnostics, Sanofi. Speaker's Bureau; Dr. Reddy’s Laboratories Ltd., Lupin Pharmaceuticals, Inc., USV Private Limited. K. Kumar: None. A. Mithal: Advisory Panel; Eris Lifesciences Ltd. Consultant; Glenmark Pharmaceuticals, Lupin Pharmaceuticals, Inc., USV Private Limited. Speaker's Bureau; Abbott Diabetes, AstraZeneca, Biocon, Boehringer Ingelheim International GmbH, Dr. Reddy’s Laboratories Ltd., Novartis AG, Novo Nordisk, Sanofi. S. Kalra: Speaker's Bureau; Boehringer Ingelheim International GmbH, Novo Nordisk A/S, Sanofi. A. Unnikrishnan: Advisory Panel; Intas Pharmaceuticals Ltd. Speaker's Bureau; Abbott, AstraZeneca, Boehringer-Ingelheim, Sanofi. Other Relationship; Novo Nordisk, Serdia Pharmaceuticals (India) Pvt. Ltd., Torrent Pharmaceuticals Ltd. H. Thacker: None. B. Sethi: None. S. Chowdhury: None. A. Nair: None. S. Mohanasundaram: Employee; Sanofi. V. Salvi: Employee; Sanofi. D. Chodankar: Employee; Sanofi. C. Trivedi: None. S. Wangnoo: None. A.H. Zargar: Advisory Panel; Sanofi. Speaker's Bureau; AstraZeneca, Biocon, Boehringer Ingelheim International GmbH, Intas Pharmaceuticals Ltd., Janssen Pharmaceuticals, Inc., Lupin Pharmaceuticals, Inc., Novo Nordisk, USV Private Limited. N. Rais: None. Funding Sanofi, India

Macrovascular and microvascular complications were evaluated during the first 2 years of LANDMARC, a 3-year prospective observational study (CTRI/2017/05/008452) that included participants with T2D on ≥2 antihyperglycemic medications. Out of 6234 evaluable participants (mean baseline values - age: 52.1 years, T2D duration: 8.59 years and A1C: 8.05%) , 5318 participants completed the 2-year follow-up. The mean A1C decreased by 0.58% (baseline: 8.05%) in 2 years. The microvascular complications were frequent in 17.6% participants (1096/6234) ; while the incidence of macrovascular complications was 1.1% participants (66/6234) . Neuropathy was the most commonly reported complication (baseline: 11.8% and 2-years: 14.4%) . Overall, complications were more common in participants with BMI ≥23 kg/m2, A1C ≥7% or having CV risk factors (Table) . A total of 41 deaths were reported; of which 30 deaths were attributed to CV causes (sudden death [n=19], myocardial infarction [n=9], stroke [n=1], and coronary artery procedure [n=1]) . The 2-year results indicate more complications among those who were overweight, or with suboptimal glycemic control or having CV risk factors. Neuropathy was the predominant T2D complication. These results offer insights into disease progression and suggest the need for controlling risk factors and timely treatment adjustment in participants with T2D. Disclosure N. Rais: None. A.K. Das: Advisory Panel; Boehringer Ingelheim International GmbH, Novo Nordisk, Roche Diagnostics, Sanofi. Speaker's Bureau; Dr. Reddy’s Laboratories Ltd., Lupin Pharmaceuticals, Inc., USV Private Limited. S. Joshi: Advisory Panel; Abbott, Boehringer Ingelheim International GmbH, Dr. Reddy’s Laboratories Ltd., Eli Lilly and Company, Novo Nordisk, Roche Diabetes Care. Consultant; Biocon, Glenmark Pharmaceuticals, Sanofi, USV Private Limited. A. Mithal: Advisory Panel; Eris Lifesciences Ltd. Consultant; Glenmark Pharmaceuticals, Lupin Pharmaceuticals, Inc., USV Private Limited. Speaker's Bureau; Abbott Diabetes, AstraZeneca, Biocon, Boehringer Ingelheim International GmbH, Dr. Reddy’s Laboratories Ltd., Novartis AG, Novo Nordisk, Sanofi. S. Kalra: Speaker's Bureau; Boehringer Ingelheim International GmbH, Novo Nordisk A/S, Sanofi. A. Unnikrishnan: Advisory Panel; Intas Pharmaceuticals Ltd. Speaker's Bureau; Abbott, AstraZeneca, Boehringer-Ingelheim, Sanofi. Other Relationship; Novo Nordisk, Serdia Pharmaceuticals (India) Pvt. Ltd., Torrent Pharmaceuticals Ltd. H. Thacker: None. B. Sethi: None. S. Chowdhury: None. A. Nair: None. S. Mohanasundaram: Employee; Sanofi. V. Salvi: Employee; Sanofi. D. Chodankar: Employee; Sanofi. C. Trivedi: None. S. Wangnoo: None. A.H. Zargar: Advisory Panel; Sanofi. Speaker's Bureau; AstraZeneca, Biocon, Boehringer Ingelheim International GmbH, Intas Pharmaceuticals Ltd., Janssen Pharmaceuticals, Inc., Lupin Pharmaceuticals, Inc., Novo Nordisk, USV Private Limited. K. Kumar: None. Funding Sanofi, India

Therapy patterns were examined across various subgroups during the second year of LANDMARC, a 3-year prospective observational study (CTRI/2017/05/008452) that included participants with T2D on ≥2 antihyperglycemic medications. Of 6234 evaluable participants (mean baseline values - age: 52.1 years, T2D duration: 8.59 years and A1C: 8.05%) , 5318 completed 2-year follow-up visit. Therapeutic management was at the discretion of the treating physician. At the end of the second year, the proportion of participants taking insulin + OAD increased (baseline: 24.0%; 2-years: 33.3%) ; while those taking only OADs decreased (baseline: 74.4%; 2-years: 64.8%) . Among injectable glucose-lowering drugs, there was an increase in basal, prandial and premix insulin. Biguanides and sulfonylureas were the most commonly used OAD classes, the highest increase in OAD addition was seen for DPP4 inhibitors (baseline: 3049/6234, 48.9%; 2-years: 3526/5763, 61.2%) followed by SGLT2 inhibitors (baseline: 654/6234, 10.5%; 2-years: 1227/5763, 21.3%) . Overall, glycemic parameters improved in insulin vs. insulin naïve subgroup (p3 OAD subgroup. No difference in change of glycemic parameters was noted in those on basal vs. premix insulin (Table) . Overall, 2-year data indicate that timely initiation of insulin may play an important role in improving glycemic parameters. Disclosure H. Thacker: None. A.K. Das: Advisory Panel; Boehringer Ingelheim International GmbH, Novo Nordisk, Roche Diagnostics, Sanofi. Speaker's Bureau; Dr. Reddy’s Laboratories Ltd., Lupin Pharmaceuticals, Inc., USV Private Limited. S. Joshi: Advisory Panel; Abbott, Boehringer Ingelheim International GmbH, Dr. Reddy’s Laboratories Ltd., Eli Lilly and Company, Novo Nordisk, Roche Diabetes Care. Consultant; Biocon, Glenmark Pharmaceuticals, Sanofi, USV Private Limited. A. Mithal: Advisory Panel; Eris Lifesciences Ltd. Consultant; Glenmark Pharmaceuticals, Lupin Pharmaceuticals, Inc., USV Private Limited. Speaker's Bureau; Abbott Diabetes, AstraZeneca, Biocon, Boehringer Ingelheim International GmbH, Dr. Reddy’s Laboratories Ltd., Novartis AG, Novo Nordisk, Sanofi. S. Kalra: Speaker's Bureau; Boehringer Ingelheim International GmbH, Novo Nordisk A/S, Sanofi. A. Unnikrishnan: Advisory Panel; Intas Pharmaceuticals Ltd. Speaker's Bureau; Abbott, AstraZeneca, Boehringer-Ingelheim, Sanofi. Other Relationship; Novo Nordisk, Serdia Pharmaceuticals (India) Pvt. Ltd., Torrent Pharmaceuticals Ltd. K. Kumar: None. B. Sethi: None. S. Chowdhury: None. A. Nair: None. S. Mohanasundaram: Employee; Sanofi. V. Salvi: Employee; Sanofi. D. Chodankar: Employee; Sanofi. C. Trivedi: None. S. Wangnoo: None. A.H. Zargar: Advisory Panel; Sanofi. Speaker's Bureau; AstraZeneca, Biocon, Boehringer Ingelheim International GmbH, Intas Pharmaceuticals Ltd., Janssen Pharmaceuticals, Inc., Lupin Pharmaceuticals, Inc., Novo Nordisk, USV Private Limited. N. Rais: None. Funding Sanofi, India

There are few studies on type 2 diabetes complications from Indian metropolitan and non-metropolitan cities. Macrovascular and microvascular complications during the second year of LANDMARC, a 3-year nationwide prospective observational study (CTRI/2017/05/008452) , were evaluated in participants from metropolitan versus non-metropolitan cities. LANDMARC included participants with T2D who were on ≥2 antihyperglycemic medications. Of the total 6234 participants, 2376 and 3858 were from metropolitan and non-metropolitan cities, respectively. Age, T2D duration, and baseline A1C were similar across groups. Microvascular complications were significantly higher in participants from non-metropolitan than metropolitan cities (12.93% vs. 4.65%; p Disclosure S. Kalra: Speaker's Bureau; Boehringer Ingelheim International GmbH, Novo Nordisk A/S, Sanofi. A.K. Das: Advisory Panel; Boehringer Ingelheim International GmbH, Novo Nordisk, Roche Diagnostics, Sanofi. Speaker's Bureau; Dr. Reddy’s Laboratories Ltd., Lupin Pharmaceuticals, Inc., USV Private Limited. S. Joshi: Advisory Panel; Abbott, Boehringer Ingelheim International GmbH, Dr. Reddy's Laboratories Ltd., Eli Lilly and Company, Novo Nordisk, Roche Diabetes Care. Consultant; Biocon, Glenmark Pharmaceuticals, Sanofi, USV Private Limited. A. Mithal: Advisory Panel; Eris Lifesciences Ltd. Consultant; Glenmark Pharmaceuticals, Lupin Pharmaceuticals, Inc., USV Private Limited. Speaker's Bureau; Abbott Diabetes, AstraZeneca, Biocon, Boehringer Ingelheim International GmbH, Dr. Reddy’s Laboratories Ltd., Novartis AG, Novo Nordisk, Sanofi. K. Kumar: None. A. Unnikrishnan: Advisory Panel; Intas Pharmaceuticals Ltd. Speaker's Bureau; Abbott, AstraZeneca, Boehringer-Ingelheim, Sanofi. Other Relationship; Novo Nordisk, Serdia Pharmaceuticals (India) Pvt. Ltd., Torrent Pharmaceuticals Ltd. H. Thacker: None. B. Sethi: None. S. Chowdhury: None. A. Nair: None. S. Mohanasundaram: Employee; Sanofi. V. Salvi: Employee; Sanofi. D. Chodankar: Employee; Sanofi. C. Trivedi: None. S. Wangnoo: None. A.H. Zargar: Advisory Panel; Sanofi. Speaker's Bureau; AstraZeneca, Biocon, Boehringer Ingelheim International GmbH, Intas Pharmaceuticals Ltd., Janssen Pharmaceuticals, Inc., Lupin Pharmaceuticals, Inc., Novo Nordisk, USV Private Limited. N. Rais: None. Funding Sanofi, India

Glycemic trends of T2D from metropolitan and non-metropolitan cities of India have been less studied and hence, were evaluated during the second year of LANDMARC trial (a 3-year nationwide prospective observational study; CTRI/2017/05/008452) . A total of 5318 of 6234 evaluable participants with T2D taking ≥2 antihyperglycemic medications (with/without glycemic control) completed 2-year follow-up visit. The age, T2D duration, baseline A1C were comparable across participants from metropolitan and non-metropolitan cities. At 2-year, a decrease in all glycemic parameters was noted. There was a noticeable improvement in A1C levels from baseline in participants from metropolitan and non-metropolitan cities (mean [95% CI]: −0.5% [−0.6, −0.4] and −0.7% [−0.8, −0.6]; p=0.0450, respectively) . Almost, one-third of the participants in metropolitan (491/16[30.6%]) and non-metropolitan (806/2280 [35.4%]) cities achieved glycemic control (A1C Disclosure A. Unnikrishnan: Advisory Panel; Intas Pharmaceuticals Ltd. Speaker's Bureau; Abbott, AstraZeneca, Boehringer-Ingelheim, Sanofi. Other Relationship; Novo Nordisk, Serdia Pharmaceuticals (India) Pvt. Ltd., Torrent Pharmaceuticals Ltd. A.K. Das: Advisory Panel; Boehringer Ingelheim International GmbH, Novo Nordisk, Roche Diagnostics, Sanofi. Speaker's Bureau; Dr. Reddy’s Laboratories Ltd., Lupin Pharmaceuticals, Inc., USV Private Limited. S. Joshi: Advisory Panel; Abbott, Boehringer Ingelheim International GmbH, Dr. Reddy’s Laboratories Ltd., Eli Lilly and Company, Novo Nordisk, Roche Diabetes Care. Consultant; Biocon, Glenmark Pharmaceuticals, Sanofi, USV Private Limited. A. Mithal: Advisory Panel; Eris Lifesciences Ltd. Consultant; Glenmark Pharmaceuticals, Lupin Pharmaceuticals, Inc., USV Private Limited. Speaker's Bureau; Abbott Diabetes, AstraZeneca, Biocon, Boehringer Ingelheim International GmbH, Dr. Reddy’s Laboratories Ltd., Novartis AG, Novo Nordisk, Sanofi. S. Kalra: Speaker's Bureau; Boehringer Ingelheim International GmbH, Novo Nordisk A/S, Sanofi. K. Kumar: None. H. Thacker: None. B. Sethi: None. S. Chowdhury: None. A. Nair: None. S. Mohanasundaram: Employee; Sanofi. V. Salvi: Employee; Sanofi. D. Chodankar: Employee; Sanofi. C. Trivedi: None. S. Wangnoo: None. A.H. Zargar: Advisory Panel; Sanofi. Speaker's Bureau; AstraZeneca, Biocon, Boehringer Ingelheim International GmbH, Intas Pharmaceuticals Ltd., Janssen Pharmaceuticals, Inc., Lupin Pharmaceuticals, Inc., Novo Nordisk, USV Private Limited. N. Rais: None. Funding Sanofi, India

Therapy patterns were examined across various subgroups during the first year of LANDMARC, a 3-year prospective observational study (CTRI/2017/05/008452) that included patients with T2D on ≥2 antihyperglycemic medications. Of 6236 patients (mean baseline values - age: 52.1 years, T2D duration: 8.6 years and A1C: 8.05%) enrolled, 5654 completed 1-year follow-up visit. Therapeutic management was at the discretion of the treating physician. At the end of the first year, the proportion of patients taking insulin + OAD increased (baseline: 24%; 1-year: 30.7%); while, those taking only OADs decreased (baseline: 74.4%; 1-year: 67.3%). Biguanides and sulfonylureas were the most commonly used OAD classes, the highest increase in use was seen for DPP4 inhibitors (baseline: 48.9%; 1-year: 58.7%). Overall, at 1-year, glycemic parameters improved significantly (p≤0.001); HbA1c improved more in the insulin versus insulin naive subgroup (p 3 versus ≤3 OADs. All glycemic parameters improved in those receiving basal or premix insulins. Overall, 1-year data indicate that timely initiation of insulin may play an important role in improving glycemic parameters. Disclosure H. Thacker: None. R. Ghosh: Employee; Self; Sanofi. S. Krishnan: Employee; Self; Sanofi. A. Nair: Employee; Self; Sanofi. S. Mohanasundaram: Employee; Self; Sanofi. S. K. Menon: Employee; Self; Sanofi. V. Salvi: Employee; Self; Sanofi. D. Chodankar: Employee; Self; Sanofi. C. Trivedi: None. S. Wangnoo: None. A. H. Zargar: None. A. K. Das: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Novo Nordisk, Roche Pharma, Sanofi. N. Rais: None. S. Joshi: Advisory Panel; Self; Abbott, AstraZeneca, Biocon, Franco Indian, Glenmark, Lupin, Marico, Roche, Twinhealth, Zydus, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novartis Pharmaceuticals Corporation, Novo Nordisk, Sanofi, Serdia Pharmaceuticals (India) Pvt. Ltd. A. Mithal: Advisory Panel; Self; Eris Lifesciences Limited, Consultant; Self; Glenmark Pharmaceuticals Limited, Lupin Pharmaceuticals, Inc., USV Private Limited, Speaker’s Bureau; Self; Abbott, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Intas Pharmaceuticals Ltd., Novo Nordisk, Sanofi. S. Kalra: Speaker’s Bureau; Self; Eli Lilly and Company, Novo Nordisk, Sanofi. A. Unnikrishnan: Advisory Panel; Self; Sanofi-Aventis, Other Relationship; Self; Novo Nordisk A/S, Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Lilly Diabetes. K. Kumar: Advisory Panel; Self; Sanofi-Aventis. B. Sethi: None. S. Chowdhury: None. Funding Sanofi

Real-world data on the effectiveness and safety of Gla-100 is limited in Indian people with T2DM. In a post-hoc analysis the effectiveness and hypoglycemia risk was studied in Indian T2DM participants (N=955) who started Gla-100 under daily routine practice and were followed-up for 6 months in the observational FINE-ASIA (overall N=2679) and GOAL (overall N=2704) registries. Mean age and duration of diabetes were 54.7±9.8 years and 9.8±6.3 years, respectively. HbA1c, FPG, body weight, dose, and incidence of hypoglycemia outcomes are summarized in Table. Mean HbA1c and FPG were significantly reduced after 6 months of Gla-100 treatment (-2.07±1.42%; -94.4±65.2 mg/dL). HbA1c targets of Disclosure V. C. Deshmukh: None. S. Mohanasundaram: Employee; Self; Sanofi. C. Trivedi: None. V. Salvi: Employee; Self; Sanofi. P. R. Narvekar: None. S. Kale: None. S. Ramakrishnan: None. G. Goyal: Advisory Panel; Self; Sanofi. T. Chaudhury: None. M. Chadha: Advisory Panel; Self; Sanofi, Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Novo Nordisk Pharma Ltd. M. S. Chawla: Speaker’s Bureau; Self; Abbott Diabetes, Boehringer Ingelheim Pharmaceuticals, Inc., Colgate-Palmolive, Eli Lilly and Company, Glenmark Pharmaceuticals Limited, Novo Nordisk. S. Mukherjee: None. S. U. Pitale: Speaker’s Bureau; Self; Sanofi. D. Basu: None. R. Ghosh: Employee; Self; Sanofi. A. Nair: Employee; Self; Sanofi. Funding Sanofi India

Data on glycemic status in patients with diabetes from metropolitan and non-metropolitan cities of India are unavailable. Hence, glycemic trend was evaluated among patients from metropolitan versus non-metropolitan cities during the first year of LANDMARC trial (a 3-year nationwide prospective observational study; CTRI/2017/05/008452). A total of 6236 patients with type 2 diabetes (T2D) taking ≥2 antihyperglycemic medications (with/without glycemic control) were enrolled, of which 5654 completed 1-year follow-up visit. The age, T2D duration, baseline A1C were comparable across patients from metropolitan and non-metropolitan cities (Table). At 1-year, a decrease in all glycemic parameters was noted. However, the difference in fall in A1C from baseline between patients from metropolitan and non-metropolitan cities was not significant (mean [95% CI]: -0.5% [-0.5, -0.4] vs. -0.5% [-0.5, -0.4]; p=0.86). For FPG and PPG, the difference in change from baseline between the two groups was also not significant (p>0.05) (Table). In the first-year, patients from both metropolitan and non-metropolitan cities showed marked improvement in glycemic status with similar trends for change in glycemic parameters. These results help compare the longitudinal glycemic patterns among patients with T2D in metropolitan and non-metropolitan cities across India. Disclosure A. Unnikrishnan: Advisory Panel; Self; Sanofi-Aventis, Other Relationship; Self; Novo Nordisk A/S, Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Lilly Diabetes. R. Ghosh: Employee; Self; Sanofi. S. Krishnan: Employee; Self; Sanofi. A. Nair: Employee; Self; Sanofi. S. Mohanasundaram: Employee; Self; Sanofi. S. K. Menon: Employee; Self; Sanofi. V. Salvi: Employee; Self; Sanofi. D. Chodankar: Employee; Self; Sanofi. C. Trivedi: None. S. Wangnoo: None. A. H. Zargar: None. A. K. Das: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Novo Nordisk, Roche Pharma, Sanofi. N. Rais: None. S. Joshi: Advisory Panel; Self; Abbott, AstraZeneca, Biocon, Franco Indian, Glenmark, Lupin, Marico, Roche, Twinhealth, Zydus, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novartis Pharmaceuticals Corporation, Novo Nordisk, Sanofi, Serdia Pharmaceuticals (India) Pvt. Ltd. A. Mithal: Advisory Panel; Self; Eris Lifesciences Limited, Consultant; Self; Glenmark Pharmaceuticals Limited, Lupin Pharmaceuticals, Inc., USV Private Limited, Speaker’s Bureau; Self; Abbott, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Intas Pharmaceuticals Ltd., Novo Nordisk, Sanofi. S. Kalra: Speaker’s Bureau; Self; Eli Lilly and Company, Novo Nordisk, Sanofi. K. Kumar: Advisory Panel; Self; Sanofi-Aventis. H. Thacker: None. B. Sethi: None. S. Chowdhury: None. Funding Sanofi

Glycemic change from baseline to 6-months was examined across various subgroups during first 6-months observational period in this 3 year prospective study (LANDMARC; CTRI/2017/05/008452). Descriptive statistics was used to assess glycemic trends in adults with T2D controlled/uncontrolled on ≥2 antihyperglycemic medications. Of 6236 enrolled participants, 5703 completed 6-month follow-up (visit 2 [V2]). A significant (p Disclosure R. Ghosh: Employee; Self; Sanofi. A.K. Das: Advisory Panel; Self; Novo Nordisk A/S, Sanofi. A. Mithal: Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Johnson & Johnson, Lilly Diabetes, Novo Nordisk A/S. S. Joshi: Advisory Panel; Self; Novo Nordisk A/S, Roche Pharma, Sanofi. K. Kumar: None. S. Kalra: Advisory Panel; Self; Eli Lilly and Company. Speaker’s Bureau; Self; Novo Nordisk A/S, Sanofi-Aventis. A. Unnikrishnan: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk Inc., Sanofi. Speaker’s Bureau; Self; Eli Lilly and Company, Ipca Laboratories, Merck Sharp & Dohme Corp., Novartis AG. H. Thacker: None. B. Sethi: None. S. Mohanasundaram: Employee; Self; Sanofi. S.K. Menon: None. A. Nair: Employee; Self; Sanofi. N. Rais: None. S. Wangnoo: None. S. Chowdhury: Advisory Panel; Self; Novo Nordisk A/S. A.H. Zargar: None. Funding Sanofi India Limited

LANDMARC (CTRI/2017/05/008452) aims to evaluate the development and progression of diabetes complications over 3 years in Indian participants with T2D. Rate of diabetes complications was compared from baseline to 6 months (visit 2 [V2]) using McNemar’s test and Chi square test (when complications were stratified in subgroups). There was an increase in the rate of microvascular complications by V2 (Table). Microvascular complications were reported more commonly in participants with A1C≥7% than A1C Disclosure R. Ghosh: Employee; Self; Sanofi. A.K. Das: Advisory Panel; Self; Novo Nordisk A/S, Sanofi. S. Joshi: Advisory Panel; Self; Novo Nordisk A/S, Roche Pharma, Sanofi. A. Mithal: Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Johnson & Johnson, Lilly Diabetes, Novo Nordisk A/S. K. Kumar: None. S. Kalra: Advisory Panel; Self; Eli Lilly and Company. Speaker’s Bureau; Self; Novo Nordisk A/S, Sanofi-Aventis. A. Unnikrishnan: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk Inc., Sanofi. Speaker’s Bureau; Self; Eli Lilly and Company, Ipca Laboratories, Merck Sharp & Dohme Corp., Novartis AG. H. Thacker: None. B. Sethi: None. S. Mohanasundaram: Employee; Self; Sanofi. S.K. Menon: None. A. Nair: Employee; Self; Sanofi. N. Rais: None. S. Wangnoo: None. S. Chowdhury: Advisory Panel; Self; Novo Nordisk A/S. A.H. Zargar: None. Funding Sanofi India Limited

Impact of cardiovascular (CV) risk factors in participants with T2D during the first 6-months of observational period were examined in this 3 year prospective study (LANDMARC; CTRI/2017/05/008452). CV risk factors (rate of hypertension, dyslipidemia, albuminuria, and family history of premature coronary disease) at baseline (V1) and 6 months (Visit 2 [V2]) were assessed and compared between subgroups. Overall, >50% of the participants who had A1C data available, had CV risks at both V1 (2385/4479; 53.2%) and V2 (2422/4479; 54.1%). More than half of the participants with obesity (BMI ≥25 kg/m2) had CV risks at V1 (2305/4150; 55.5%) and V2 (2340/4150; 56.4%). On comparing the insulin (N=1548) vs. insulin naïve (N=4688) subgroups, a higher proportion of participants on insulin had CV risks than those who were insulin naïve (V1: 60.1% vs. 50.1%; V2: 60.8% vs. 50.9%). At V2, hypertension and dyslipidemia were more predominant in those with BMI ≥23 kg/m2 than Disclosure R. Ghosh: Employee; Self; Sanofi. A.K. Das: Advisory Panel; Self; Novo Nordisk A/S, Sanofi. S. Joshi: Advisory Panel; Self; Novo Nordisk A/S, Roche Pharma, Sanofi. A. Mithal: Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Johnson & Johnson, Lilly Diabetes, Novo Nordisk A/S. K. Kumar: None. S. Kalra: Advisory Panel; Self; Eli Lilly and Company. Speaker’s Bureau; Self; Novo Nordisk A/S, Sanofi-Aventis. A. Unnikrishnan: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk Inc., Sanofi. Speaker’s Bureau; Self; Eli Lilly and Company, Ipca Laboratories, Merck Sharp & Dohme Corp., Novartis AG. H. Thacker: None. B. Sethi: None. S. Mohanasundaram: Employee; Self; Sanofi. S.K. Menon: None. A. Nair: Employee; Self; Sanofi. N. Rais: None. S. Wangnoo: None. S. Chowdhury: Advisory Panel; Self; Novo Nordisk A/S. A.H. Zargar: None. Funding Sanofi India Limited

Therapy patterns were examined across various subgroups during the first 6-months of this 3 year prospective longitudinal study (LANDMARC; CTRI/2017/05/008452). During the observational period investigators were free to modify treatment in adults with T2D controlled/uncontrolled on ≥2 antihyperglycemic medications. Treatment patterns were analyzed using descriptive statistics and paired t-test. From baseline to 6-months (visit 2 [V2]), glycemic parameters analyzed for 5703 subjects improved significantly (p3 OADs vs. ≤3 OADs was noted in insulin naïve subgroup. Notably, in participants receiving insulin along with OADs, PPG improved more in basal vs. premix regimen (p=0.0024). Overall, insulin regimen was more effective than OADs. Intensification of treatment with >3 OADs may not be effective in improving glycemic parameters. In real-world setting, adding basal insulin may be more effective than premix. Disclosure R. Ghosh: Employee; Self; Sanofi. A.K. Das: Advisory Panel; Self; Novo Nordisk A/S, Sanofi. A. Mithal: Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Johnson & Johnson, Lilly Diabetes, Novo Nordisk A/S. S. Joshi: Advisory Panel; Self; Novo Nordisk A/S, Roche Pharma, Sanofi. K. Kumar: None. S. Kalra: Advisory Panel; Self; Eli Lilly and Company. Speaker’s Bureau; Self; Novo Nordisk A/S, Sanofi-Aventis. A. Unnikrishnan: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk Inc., Sanofi. Speaker’s Bureau; Self; Eli Lilly and Company, Ipca Laboratories, Merck Sharp & Dohme Corp., Novartis AG. H. Thacker: None. B. Sethi: None. S. Mohanasundaram: Employee; Self; Sanofi. S.K. Menon: None. A. Nair: Employee; Self; Sanofi. N. Rais: None. S. Wangnoo: None. S. Chowdhury: Advisory Panel; Self; Novo Nordisk A/S. A.H. Zargar: None. Funding Sanofi India Limited