Benefit of Continuous Glucose Monitoring in Reducing Hypoglycemia Is Sustained Through 12 Months of Use Among Older Adults with Type 1 Diabetes

Miller, Kellee M.; Kanapka, Lauren; Rickels, Michael R.; Ahmann, Andrew J.; Ang, Lynn; Bhargava, Anuj; Bode, Bruce W.; Carlson, Anders; Chaytor, Naomi; Gannon, Gail; Goland, Robin; Hirsh, Irl; Kiblinger, Lisa; Kruger, Davida F.; Kudva, Yogish C.; Levy, Carol J.; McGill, Janet B.; O’Malley, Grenye; Peters, Anne L.; Philipson, Louis H.; Philis‐Tsimikas, Athena; Pop‐Busui, Rodica; Salam, Maamoun; Shah, Viral N.; Thompson, Michael; Vendrame, Francesco; Verdejo, Alandra; Young, Laura; Pratley, Richard E.

doi:10.1089/dia.2021.0503

Cited by 37 publications

(36 citation statements)

References 14 publications

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“…In a study by the Wireless Innovation for Seniors With Diabetes Mellitus study group [8], CGM users achieved an adjusted difference of -1.9 percentage points in time below 70mg/dL compared to the standard blood glucose monitoring group. This benefit was sustained after 12 months of CGM use [9].…”

Section: Discussionmentioning

confidence: 86%

“…Simpler sensor insertion and app setup processes allow the seventh-generation CGM system to be even easier for older adults to learn and use, which may aid in their motivation to try a new technology [11]. RT-CGM with its alerts and alarms has been shown to contribute to better glycemic outcomes in older adults, including severe hypoglycemia (SH), which is particularly dangerous in this population [8,9]. In a study by the Wireless Innovation for Seniors With Diabetes Mellitus study group [8], CGM users achieved an adjusted difference of -1.9 percentage points in time below 70mg/dL compared to the standard blood glucose monitoring group.…”

Section: Discussionmentioning

confidence: 99%

“…Still, diabetes self-management imposes cognitive demands and requires a significant level of expertise [7]. Recent studies demonstrated an improvement in glycemic outcomes with CGM for patients 65 years or older [8] that was sustained for an additional 12 months [9]. Although usage in older adults was very high in these studies (at least 83% of participants wore a RT-CGM device ≥6 days/week over the 6-month study period [8]), barriers still exist to broad population-level use.…”

Section: Introductionmentioning

confidence: 99%

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Usability and Teachability of Continuous Glucose Monitoring Devices in Older Adults and Diabetes Educators: Task Analysis and Ease-of-Use Survey

Psavko¹,

Katz²,

Mirchi³

et al. 2022

JMIR Hum Factors

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Background Continuous glucose monitoring (CGM) devices continuously sense and relay glucose concentration data from the interstitial fluid to a mobile phone or receiver. Older adults benefit from this continuous monitoring of glucose levels. Proper deployment of the sensing wire is facilitated by a specialized applicator. Objective Our aim was to assess a new seventh-generation (G7) CGM device (Dexcom, Inc) for use by adults 65 years of age or older and certified diabetes care and education specialists (CDCESs). Ease of use related to intradermal insertion and mobile app setup will be assessed and compared to the fifth- and sixth-generation systems. Methods Formal task analysis was conducted to enumerate the number and complexity of tasks associated with CGM deployment. We recruited 10 older adults with no prior CGM experience and 10 CDCESs to assess ease of use through hands-on insertion and initiation of a G7 system followed by a survey and, for older adults, a system usability scale survey. Results About half as many tasks are needed to deploy G7 compared to G6. Older adults and CDCESs reported overall high usability of the G7 CGM device. CDCESs noted G7’s easier setup compared to previous generations. The system usability scale score for the CGM system was 92.8, which reflects excellent usability. Conclusions For CDCESs and for older adults using the G7 CGM system, cognitive burden is relatively low and reduced compared to previous CGM systems. Easing of this burden and simplification of the glucose monitoring aspect of proper diabetes management will likely contribute to improved outcomes in this population.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Usability and Teachability of Continuous Glucose Monitoring Devices in Older Adults and Diabetes Educators: Task Analysis and Ease-of-Use Survey

Psavko¹,

Katz²,

Mirchi³

et al. 2022

JMIR Hum Factors

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“…The primary outcome was the time spent in hypo-glycaemia, defined as blood glucose <70 mg/ The authors concluded that CGM should be considered as a standard of care for older adults living with type 1 diabetes, given their hypoglycaemic vulnerability. 32 MOBILE was an 8-month randomized trial that compared the use of CGM with conventional blood glucose monitoring in people living with type 2 diabetes on basal insulin. 33…”

Section: Clinical Studies Of Continuous Glucose Monitoring In Older A...mentioning

confidence: 99%

“…The authors concluded that CGM should be considered as a standard of care for older adults living with type 1 diabetes, given their hypo-glycaemic vulnerability. 32 …”

Section: Clinical Studies Of Continuous Glucose Monitoring In Older A...mentioning

confidence: 99%

Use of Continuous Glucose Monitoring in Older Adults: A Review of Benefits, Challenges and Future Directions

Prasad-Reddy¹,

Godina²,

Chetty³

et al. 2022

European Endocrinology

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Many new technologies have been developed over the past decade, and these have substantially changed the way diabetes is managed. Continuous glucose monitoring is now the standard of care for many people living with diabetes, and among its numerous benefits, it has been shown to improve glycaemic outcomes and enhance quality of life. Older adults carry a high burden of diabetes and have a high risk of hypo-glycaemia and hypo-glycaemic unawareness, and continuous glucose monitoring can help to improve glycaemic management in this vulnerable population. Unfortunately, only a few trials have evaluated the effectiveness of continuous glucose monitoring in older adults. Certainly, the implementation of continuous glucose monitoring in older adults can come with many challenges, including logistical, educational and reimbursement barriers. This article will discuss the benefits of continuous glucose monitoring in older adults with diabetes, the clinical studies that support its use and the barriers to its optimal implementation in this population.

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Guideline for the Management of Diabetes Mellitus in the Elderly in China (2024 Edition)

Guo,

Xiao

2024

Aging Medicine

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With the deepening of aging in China, the prevalence of diabetes in older people has increased noticeably, and standardized diabetes management is critical for improving clinical outcomes of diabetes in older people. In 2021, the National Center of Gerontology, Chinese Society of Geriatrics, and Diabetes Professional Committee of Chinese Aging Well Association organized experts to write the first guideline for diabetes diagnosis and treatment in older people in China, the Guideline for the Management of Diabetes Mellitus in the Elderly in China (2021 Edition). The guideline emphasizes that older patients with diabetes are a highly heterogeneous group requiring comprehensive assessment and stratified and individualized management strategies. The guideline proposes simple treatments and de‐intensified treatment strategies for older patients with diabetes. This edition of the guideline provides clinicians with practical and operable clinical guidance, thus greatly contributing to the comprehensive and full‐cycle standardized management of older patients with diabetes in China and promoting the extensive development of clinical and basic research on diabetes in older people and related fields. In the past 3 years, evidence‐based medicine for older patients with diabetes and related fields has further advanced, and new treatment concepts, drugs, and technologies have been developed. The guideline editorial committee promptly updated the first edition of the guideline and compiled the Guideline for the Management of Diabetes Mellitus in the Elderly in China (2024 Edition). More precise management paths for older patients with diabetes are proposed, for achieving continued standardization of the management of older Chinese patients with diabetes and improving their clinical outcomes.

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Benefit of Continuous Glucose Monitoring in Reducing Hypoglycemia Is Sustained Through 12 Months of Use Among Older Adults with Type 1 Diabetes

Cited by 37 publications

References 14 publications

Usability and Teachability of Continuous Glucose Monitoring Devices in Older Adults and Diabetes Educators: Task Analysis and Ease-of-Use Survey

Usability and Teachability of Continuous Glucose Monitoring Devices in Older Adults and Diabetes Educators: Task Analysis and Ease-of-Use Survey

Use of Continuous Glucose Monitoring in Older Adults: A Review of Benefits, Challenges and Future Directions

Guideline for the Management of Diabetes Mellitus in the Elderly in China (2024 Edition)

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