PDB13 ASSOCIATION OF VERAPAMIL THERAPY AND REDUCED HYPOGLYCEMIC EVENTS AMONG MEDICARE PATIENTS WITH NEWLY DIAGNOSED TYPE 1 DIABETES

A recent clinical trial suggests that verapamil may slow type 1 diabetes (T1D) progression(Ovalle et al, 2018). This study seeks to describe the relationship between verapamil and T1D from a novel perspective, examining whether the proposed protective effect extends to a reduction in hypoglycemicevents among Medicare patients with newly diagnosed T1D. We performed retrospective cohort analysis using pharmacy and medical claims by examining a 20% random sample of Medicare beneficiaries from 2006-2014. We identified hypertension patients aged 65 years or older who were diagnosed T1D during those years and satisfied our sample inclusion criteria. Our main analyses employed a multivariate Poisson regression of the relation between verapamil use measured by 30-day prescription fills of verapamil in the 12-month period following onset, and the number of acute hospital admission or emergency department visits for hypoglycemia during the 12-month period following the index date. We then examined the equality of the association across the different demographics. Our study sample included 1,649 fee for service beneficiaries who had fills of verapamil during 12 months after T1D onset. The adjusted Poisson regression model showed that 10% increase in the administration of verapamil is associated with 5.9% (p-value=0.025; 95% confidence interval: -10.8% to -0.9%) reduction of acute hospital admissions or ER visits for hypoglycemia. This finding implies that additional 30-day fills decrease the outcome of the patients at the median, the first, and the third quartile levels of 30-day fills by 5.3%, 8.4%, and 4.9% respectively. This negative relation was larger for white than non-white (-17.4% in response to 10% increment of verapamil use for white verses 4.7% for non-white; p-value=0.024 for the difference). This study provides real-world evidence on the negative association between verapamil use and hospital admission/ER visits for hypoglycemia. The finding suggests the possibility of the protective effect of verapamil on T1D.