Use of Continuous Glucose Monitoring in Insulin-Treated Older Adults with Type 2 Diabetes

Abstract

Abstract Background Few studies have reported on the adherence and efficacy of continuous glucose monitoring (CGM) in improving diabetes management in insulin-treated older adults with type 2 diabetes mellitus (T2DM). Methods Prospective observational cohort study using FreeStyle Libre Flash CGM in insulin-treated adults > 65 years with T2DM and HbA1c between 7% and 9%. Participants wore the CGM during a 6-weeks study period. The primary outcome was time in range (TIR) between 70–180 mg/dl. Secondary outcomes included time below range (TBR), glycemic variability (GV), adherence, and use of glucose data for self-insulin adjustment. Results A total of 66 participants completed the six weeks of CGM (age 72·8 ± 5·3 years; BMI 27·8 ± 3·6 kg/m2), HbA1c: 8·0 ± 0·6%, with an overall sensor utilization of 93·1 ± 6·0%. Compared to baseline, we observed stability in TIR (67% vs. 70%, p = 0.190, and a significant reduction in glucose variability (34·9 ± 7·2 vs. 32·9 ± 6·8, p = < 0.001) and in TBR (4% vs. 2%, p = 0.008). Conclusion The FreeStyle Libre Flash CGM was well accepted by older adults with T2DM and allowed participants to make therapy decisions to improve TIR and reduce TBR and glycemic variability. This real-world study indicates that CGM is safe and effective in improving glycemic control and should be offered to insulin-treated older adults with T2DM.