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

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.