Nationwide Study in France Shows Dramatic Drop in DKA in Type 1 and Type 2 After Starting on FreeStyle Libre


On June 13, study results presented at the ADA 80th Scientific Sessions showed a dramatic drop in diabetic ketoacidosis (DKA) rates for people living with diabetes after adopting Abbott’s FreeStyle Libre system.

The nationwide study in France looked at retrospective data of more that 70,000 patients living with diabetes who began using the continuous glucose monitor (CGM) between August 1 2017 and December 1 2017. Of those participants, 33,203 were living with type 1 diabetes and 40,955 were living with type 2 diabetes. Researchers analyzed how often these participants were treated for DKA using the ICD-10 codes in the French nationwide reimbursement claim database.

Patients were also separated into groups by how often they did self-monitoring blood glucose testing (SMBG – how often they checked their blood sugar.)

Overall DKA rates were reduced in the year following FreeStyle Libre system initiation by 52 percent for patients with type 1 diabetes (T1D) and 47 percent for patients with type 2 diabetes (T2D). The results were expectedly even more impressive for those who had not been monitoring their blood sugar prior to (60 percent reduction in T1D, 51 percent in T2D). The reduction in hospitalization rates was observed for people using insulin pumps as well as those on multiple daily injection (MDI).


“This was a dramatic reduction in ketoacidosis-related hospitalization rates among patients with both type 1 and type 2 diabetes—especially among people who previously had very low self-monitoring of blood glucose—and supports the use of intermittently scanned continuous glucose monitoring systems like the FreeStyle Libre for individuals who are at risk for diabetes-related complications such as diabetic ketoacidosis,” said lead study author Ronan Roussel, MD, PhD, chief of the endocrinology, diabetes and nutrition department at Hôpital Bichat, Fédération de Diabétologie, AP-HP, Paris, France. “It is plausible that the use of the FreeStyle Libre system allowed people to detect and limit persistent hyperglycemia, and subsequently prevent ketoacidosis. Although preventing ketoacidosis has traditionally relied on intensive self-monitoring of blood glucose, there is growing literature that shows this has not helped reduce the overall incidence of diabetic ketoacidosis. The positive results of this study demonstrate that intermittently scanned continuous glucose monitoring may have significant implications for patient-centered clinical care and, given the increased burden of ketoacidosis on healthcare utilization and expenditure, it may have a positive impact on long-term economic health outcomes.”

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WRITTEN BY Todd Boudreaux, POSTED 06/13/20, UPDATED 11/23/22

Todd was diagnosed with type 1 diabetes in 2000, and has been unofficially advocating for type 1 diabetes (T1D) ever since. Before joining the team at Beyond Type 1, Todd wrote and produced television shows for Discovery Channel, Travel Channel and Animal Planet. When he’s not in the office, you can usually find him at a baseball game, traveling, or drawing on his Etch A Sketch. You can also follow him on Instagram.