Older Adults Benefit From Virtual Support for Continuous Glucose Monitor Use But Require Longer Visits.

IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM
Ruth S Weinstock, Dan Raghinaru, Robin L Gal, Richard M Bergenstal, Amy Bradshaw, Terra Cushman, Craig Kollman, Davida Kruger, Mary L Johnson, Teresa McArthur, Beth A Olson, Sean M Oser, Tamara K Oser, Roy W Beck, Korey Hood, Grazia Aleppo
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Abstract

Background: Older adults may be less comfortable with continuous glucose monitoring (CGM) technology or require additional education to support use. The Virtual Diabetes Specialty Clinic study provided the opportunity to understand glycemic outcomes and support needed for older versus younger adults living with diabetes and using CGM.

Methods: Prospective, virtual study of adults with type 1 diabetes (T1D, N = 160) or type 2 diabetes (T2D, N = 74) using basal-bolus insulin injections or insulin pump therapy. Remote CGM diabetes education (3 scheduled visits over 1 month) was provided by Certified Diabetes Care and Education Specialists with additional visits as needed. CGM-measured glycemic metrics, HbA1c and visit duration were evaluated by age (<40, 40-64 and ≥65 years).

Results: Median CGM use was ≥95% in all age groups. From baseline to 6 months, time 70 to 180 mg/dL improved from 45% ± 22 to 57% ± 16%; 50 ± 25 to 65 ± 18%; and 60 ± 28 to 69% ± 18% in the <40, 40-64, and ≥65-year groups, respectively (<40 vs 40-64 years P = 0.006). Corresponding values for HbA1c were 8.0% ± 1.6 to 7.3% ± 1.0%; 7.9 ± 1.6 to 7.0 ± 1.0%; and 7.4 ± 1.4 to 7.1% ± 0.9% (all P > 0.05). Visit duration was 41 min longer for ages ≥65 versus <40 years (P = 0.001).

Conclusions: Adults with diabetes experience glycemic benefit after remote CGM use training, but training time for those >65 years is longer compared with younger adults. Addressing individual training-related needs, including needs that may vary by age, should be considered.

老年人受益于连续血糖监测仪使用的虚拟支持,但需要更长时间的访问。
背景:老年人可能不太习惯使用连续血糖监测(CGM)技术,或者需要额外的教育来支持使用。虚拟糖尿病专科门诊研究为了解老年糖尿病患者与年轻糖尿病患者使用 CGM 的血糖结果和所需支持提供了机会:方法:对使用基础胰岛素注射或胰岛素泵治疗的 1 型糖尿病(T1D,160 人)或 2 型糖尿病(T2D,74 人)成人进行前瞻性虚拟研究。认证糖尿病护理和教育专家提供远程 CGM 糖尿病教育(1 个月内 3 次预定访问),并根据需要进行额外访问。按年龄对 CGM 测量的血糖指标、HbA1c 和就诊时间进行了评估(结果:所有年龄组的 CGM 使用率中位数均≥95%。从基线到 6 个月,70 至 180 mg/dL 的时间从 45% ± 22 提高到 57% ± 16%;50 ± 25 提高到 65 ± 18%;60 ± 28 提高到 69% ± 18%(P = 0.006)。HbA1c 的相应值分别为 8.0% ± 1.6 到 7.3% ± 1.0%;7.9 ± 1.6 到 7.0 ± 1.0%;7.4 ± 1.4 到 7.1% ± 0.9%(所有 P > 0.05)。年龄≥65岁的患者就诊时间延长了41分钟(P = 0.001):结论:成人糖尿病患者在接受远程 CGM 使用培训后可获得血糖方面的益处,但与年轻人相比,年龄大于 65 岁者的培训时间更长。应考虑满足与培训相关的个人需求,包括因年龄而异的需求。
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来源期刊
Journal of Diabetes Science and Technology
Journal of Diabetes Science and Technology Medicine-Internal Medicine
CiteScore
7.50
自引率
12.00%
发文量
148
期刊介绍: The Journal of Diabetes Science and Technology (JDST) is a bi-monthly, peer-reviewed scientific journal published by the Diabetes Technology Society. JDST covers scientific and clinical aspects of diabetes technology including glucose monitoring, insulin and metabolic peptide delivery, the artificial pancreas, digital health, precision medicine, social media, cybersecurity, software for modeling, physiologic monitoring, technology for managing obesity, and diagnostic tests of glycation. The journal also covers the development and use of mobile applications and wireless communication, as well as bioengineered tools such as MEMS, new biomaterials, and nanotechnology to develop new sensors. Articles in JDST cover both basic research and clinical applications of technologies being developed to help people with diabetes.
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