2977-LB: Trends in the Prevalence of Diabetic Ketoacidosis and Severe Hypoglycemia in Type 1 Diabetes

Introduction and Objective: Diabetic ketoacidosis (DKA) and severe hypoglycemia (SH) are costly acute diabetes complications that can require emergency department (ED) and inpatient (IP) care. We estimated annual prevalence of ED/IP-treated DKA and SH among people with type 1 diabetes (T1D) from 2017-2024. Methods: We used Inovalon Insights claims, which included data from Commercial, Managed Medicaid, and Medicare Advantage plans. IP visits preceded by ED visits were solely captured as IP events. Annual prevalence was the proportion of members with T1D (per 1000) with ≥1 episode in a calendar year, stratified by pediatric (18 y/o) vs. adult and site of care (ED/IP). Primary analyses required DKA/SH as the primary diagnosis using ICD10 codes, and sensitivity analyses included events in any diagnosis position. Results: Overall DKA increased from 50 to 62 per 1,000 (2017-2024). A steeper rise in DKA events was noted in pediatrics as compared to adults: 63 to 102 vs 46 to 54 per 1,000, respectively. Prevalence of SH was low and stable. Most events led to inpatient treatment: DKA (pediatrics 94%, adults 97%) and SH (pediatrics 67%, adults 86%). Sensitivity analysis findings were consistent with primary findings. Conclusion: DKA burden in T1D remains substantial and has been increasing. In contrast, SH prevalence requiring ED/IP care has remained low and relatively stable over time. Disclosure J. Sherr: Other - research support, consultant, advisory board member; Current; Abbott Diabetes. Other - advisory board member, consultant; Current; Vertex Pharmaceuticals Incorporated. Consultant; Current; Ypsomed AG. Research Support; Current; Dexcom, Inc., JDRF, Provention Bio, Inc., National Institutes of Health. Other - research support, consultant, advisory board member; Current; Insulet Corporation, Medtronic. Research Support; Current; Sanofi. Advisory Panel; Current; sequel med tech. C. Wysham: Advisory Panel; Current; Abbott Diabetes. Speaker's Bureau; Current; Abbott Diabetes. Research Support; Ended; AbbVie Inc., Bayer AG, Novo Nordisk. Speaker's Bureau; Current; Novo Nordisk. Advisory Panel; Current; Eli Lilly and Company. Research Support; Ended; Eli Lilly and Company. Speaker's Bureau; Current; Eli Lilly and Company. Stock/Shareholder; Current; Pendulum. Speaker's Bureau; Ended; MannKind Corporation. S. Mehta: Employee; Current; Abbott Diabetes. N. Virdi: Employee; Current; Abbott Diabetes.