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89, P0.01). Among adults with diabetes absent cardiovascular disease (CVD) at baseline, 3 or more ECP visits, compared with no visits, was associated with lower odds of CVD onset (OR=0.79, P0.05). Among adults with diabetes and CVD, any ECP use was associated with lower odds of end-stage renal disease onset (OR=0.60, P0.05). ECP users had lower odds of 1 or more hospitalizations (OR=0.80, P0.001). Findings on positive patient outcomes associated with ECP use by adults with diabetes may inform IHS and Tribal policies, fundi