Real-World Study on the 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 with HbA1c between 7% and 9%. Participants wore the CGM during a 6-weeks study period. Primary outcome was time in range (TIR) between 70–180 mg/dl. Secondary outcomes included time below range (TBR), glycemic variability (GV), as well as adherence and use of glucose data for self-insulin adjustment.Results A total of 66 participants completed the 6 weeks trial (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 TIR (67% vs 70%, p = 0.190, glucose variability (34·9 ± 7·2 vs 32·9 ± 6·8, p = < 0.001), and in a significant reduction in TBR (4% vs 2%, p = 0.008).Conclusion The use of FreeStyle Libre Flash CGM was well accepted by older adults with T2DM and allowed participants to make therapy decisions to improve TIR, reduce TBR and glycemic variability. This real-world study indicates that the use of CGM is safe and effective in improving glycemic control and should be offered to insulin treated older adults with T2DM.