Incidence of Hypoglycemia Events in a Large, Real-World Diabetes Population

Abstract

Background: It is difficult to accurately determine the frequency of hypoglycemic events in a clinical setting. Remotely captured glucose data from connected meters offers an opportunity to understand real-world treatment effects outside of a clinical trial setting. The Livongo for Diabetes Program provides over 50,000 commercially-insured people with diabetes a cellular-enabled, two-way messaging device that measures and records blood glucose. Free, unlimited blood glucose test strips are also provided. Methods: We obtained blood glucose (BG) values directly from 35,436 individuals who had been using Livongo connected meters over 3 months. Frequency of BG checking, hypoglycemia event rates (BG<70 mg/dL) and clinically significant hypoglycemia event rates (BG<54mg/dL) were characterized by age, gender, race, diabetes type, estimated HbA1c and medication use. Results: The mean percentage of total BG checks <70mg/dL and <54mg/dL by medication use and diabetes type are reported in Table below. Conclusions: In a heterogeneous population with type 1 and type 2 diabetes we captured many hypoglycemic episodes, the frequency of which was associated with medication use and diabetes type. The Livongo platform provides an opportunity to understand real-world treatment effects outside of a clinical trial setting. No meds (N=3181)Oral Meds Only (N=19,135)Insulin Once Daily (N=5,315)insulin > Once Daily - T2D (N=4,606)insulin > Once Daily - T1D (N=2834)MeanSDMeanSDMeanSDMeanSDMeanSDBG<70 mg/dL1.08%3.95%1.14%4.16%3.21%7.34%3.59%6.44%10.45%10.80%BG<54 mg/dL0.20%1.24%0.26%1.85%0.89%2.83%1.19%3.92%4.36%5.88% Disclosure J. Bollyky: Employee; Self; Livongo Health. Stock/Shareholder; Self; Livongo Health. W. Lu: None. J. Schneider: Employee; Self; Livongo Health. Stock/Shareholder; Self; Livongo Health.