FRONTIER—FreeStyle Libre System Use in Ontario Among People with Diabetes Mellitus in the IC/ES Database—Evidence from Real-World Practice: Patients Using Intensive Insulin
Bibliographic record
Abstract
Background: Diabetes mellitus is associated with significant health care resource utilization (HCRU), partly due to acute complications, including diabetic ketoacidosis (DKA) and hypoglycemia. Aim: To investigate glycated hemoglobin (HbA1c) levels and HCRU before and after adoption of FreeStyle Libre Systems (FSL) in people with diabetes on multiple daily injections of insulin (MDI). Methods: This retrospective longitudinal study used administrative health data in Ontario, Canada, housed at IC/ES. The cohort comprised people with diabetes on MDI with a first FSL claim between September 16, 2019, and August 31, 2020 (index date), who remained on FSL for 24 months. HCRU (emergency department [ED] visits and hospitalization) was measured for 12 months before the index date and the last 12 months of follow-up. HbA1c data were taken from the last tests in each period. Results: Mean HbA1c was statistically significantly reduced after FSL among people with type 1 diabetes mellitus (T1DM; n = 10,510; age <25 years, −0.8%; 25–65 years, −0.5%; >65 years, −0.1%; all P < 0.0001) or type 2 diabetes mellitus (T2DM; n = 12,668; age ≤65 years, −0.6%; >65 years, −0.3%; both P < 0.0001). Overall HCRU was statistically significantly reduced in the T1DM subgroups aged <25 and 25–65 years (ED visits only) and both T2DM age subgroups, with some subgroups having statistically significant reductions in DKA- or hypoglycemia-associated HCRU. Conclusions: Among people with T1DM or T2DM on MDI, HbA1c was statistically significantly reduced after FSL, with statistically significant reductions in HCRU in some subgroups.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".