In the Journals Plus

Real-time CGM use improves perceived safety, well-being in older adults with type 1 diabetes

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April 13, 2017

Older adults with type 1 diabetes who used real-time continuous glucose monitoring were more likely to report increased awareness of hypoglycemia and improved well-being compared with those who did not use the technology, according to findings published in the Journal of Diabetes Science and Technology.

“Tactics to avoid hypoglycemia in older adults are critical to promote safety and well-being,” wrote Michelle L. Litchman, PhD, FNP-BC, FAANP, and Nancy A. Allen, PhD, ANP-BC, of the University of Utah College of Nursing in Salt Lake City. “[Real-time] CGM studies have traditionally excluded older individuals and, therefore, little is known about older adults and [real-time] CGM use. The purpose of this study was to identify why [real-time] CGM was important for diabetes management in both current and former [real-time] CGM users [aged at least] 65 years.”

Litchman and Allen analyzed data from 22 older adults with type 1 diabetes, recruited from a diabetes online community, to complete one of two online surveys regarding CGM use (11 men; mean age, 70 years; mean diabetes duration, 59 years; all self-identified as high technology users). The first survey queried individuals who were current CGM users; the second queried individuals who did not use CGM but wished to do so. Questions addressed hypoglycemia (blood glucose level 70 mg/dL) and hypoglycemia unawareness.

Compared with participants who did not use real-time CGM, those who did use CGM were less likely to experience severe hypoglycemia requiring assistance of another person (P = .02) or hypoglycemia resulting in a fall or inability to operate a vehicle (P = .01). Users of CGM also reported that they were more aware of fluctuations in blood glucose and proactively made behavior adjustments to avoid hypoglycemia, according to the researchers.

Participants who were previous CGM users but currently not using the technology noted an increase in hypoglycemia-related concerns, the researchers noted, with seven nonusers reporting a severe hypoglycemia event requiring assistance of another person in the past 12 months. CGM users reported decreased worry about hypoglycemia, more restful sleep and increased independence and well-being, according to the researchers.

“Older adults without access to [real-time] CGM in this small sample experienced more severe hypoglycemia events that negatively affected their safety and well-being,” the researchers wrote. “Improving access to [real-time] CGM in older adults is critical to improving health and safety, and demands more attention from stakeholders in diabetes care.” – by Regina Schaffer

Disclosure: The researchers report no relevant financial disclosures.