68-OR: Dramatic Drop in Ketoacidosis Rate after FreeStyle Libre System Initiation in Type 1 and Type 2 Diabetes in France, Especially in People with Low Self-Monitoring of Blood Glucose (SMBG): A Nationwide Study

Abstract

Diabetic ketoacidosis is a life-threatening condition and is generally preventable through close glucose monitoring. Initiation of the FreeStyle Libre™ system could prevent ketoacidosis. We conducted a retrospective study of the ketoacidosis rates (ICD-10 codes E10.1, E11.1) on the French exhaustive nationwide reimbursement claim database in FreeStyle Libre system initiators (reimbursed from 2017/06/01). Ketoacidosis rates were recorded in the year prior to first FreeStyle Libre sensor claim (index date for initiation), and in the year after. We identified 33,203 and 40,955 people with type 1 and type 2 diabetes, respectively, initiating the FreeStyle Libre system during the study period (2017/08/01 to 2017/12/31). Overall, yearly ketoacidosis rates were reduced after FreeStyle Libre system initiation by 52% for type 1 and 47% for type 2 diabetes. Results are also presented according to the mean daily number of SMBG strips reimbursed, estimated for the year prior to FreeStyle Libre system initiation (Figure). It is plausible that the use of the FreeStyle Libre system allowed people to detect and limit persistent hyperglycemia, and subsequently ketoacidosis. The reduction of rates was marked for both types of diabetes, especially for people with very low and very high adherence to SMBG. Disclosure R. Roussel: Advisory Panel; Self; Abbott, AstraZeneca, Diabnext, Eli Lilly and Company, Merck & Co., Inc., Mundipharma International, Novo Nordisk A/S, Sanofi-Aventis. B. Guerci: Board Member; Self; Abbott. E. Vicaut: Consultant; Self; Abbott, Boston Scientific, Celgene, Pfizer Inc. G. Depouvourville: Advisory Panel; Self; Abbott, AbbVie Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc., Merck Sharp & Dohme Corp. Consultant; Self; Abbott, AbbVie Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc., Merck Sharp & Dohme Corp. B. Detournay: Advisory Panel; Self; Merck Sharp & Dohme Corp., Novo Nordisk A/S. Consultant; Self; Lilly Diabetes, Merck Sharp & Dohme Corp., Pfizer Inc., Sanofi. Employee; Self; CEMKA. C. Emery: Employee; Self; CEMKA. F. Levrat-Guillen: Employee; Self; Abbott. J. Riveline: None.