Wong Carol, De Bray Anne, Ul Hassan Naeem, Almohandes Ahmed, Thant Kyi Zin, Gill Sofia, Gill Dayna, Forsdick Hayley, Sinclair Alan J, Karamat Muhammad Ali, Bellary Srikanth
Department of Diabetes and Endocrinology, Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Centre for Endocrinology, Diabetes and Metabolism, University of Birmingham, Birmingham, UK.
Ther Adv Endocrinol Metab. 2024 Aug 20;15:20420188241269133. doi: 10.1177/20420188241269133. eCollection 2024.
Intermittently scanned continuous glucose monitoring (isCGM) has revolutionised the care of people with diabetes but its uptake and benefits in older adults are not well known. We examined the impact of isCGM (Freestyle Libre, FSL) on glycaemic outcomes in younger (⩽65 years) and older adults (>65 years) with diabetes.
In total, 2260 adult patients registered on the Libreview account at University Hospitals Birmingham NHS Foundation Trust, UK, were included. Inclusion criteria: all patients with type 1 and type 2 diabetes aged >18 years, use of isCGM >6 months, scanning at least 6 times/day. Demographics, diabetes history and glycaemic outcomes (time in range (TIR), time above range and time below range (TBR), estimated HbA1c, HbA1c at start and at end of study) were collected by accessing electronic patient records and Libreview. Outcomes were compared between age groups ⩽65 or >65 years old.
Most patients were of Caucasian ethnicity (⩽65 years 68%, >65 years 73%) and had type 1 diabetes. Mean duration of diabetes was 19.5 years (range 0-65 years) and 34.5 years (range 0-79 years) for ⩽65 and >65 years, respectively. Only a quarter of those ⩽65 years achieved (219/943; 23.2%) their age specific TIR target compared to 69% (78/113) of those >65 years cohort, while 70.1% (663/946) of ⩽65 years and 40.7% (46/113) of >65 years achieved their age-specific TBR target. When the less strict ⩽65 years TBR target was applied, 75% (85/113) of >65 years cohort achieved this.
FSL use was associated with improved glycaemic outcomes across all age groups. Individualised targets may be needed to improve TBR in those aged >65 years.
间歇性扫描式动态血糖监测（isCGM）彻底改变了糖尿病患者的护理方式，但其在老年人中的应用情况及益处尚不明确。我们研究了isCGM（FreeStyle Libre，FSL）对年轻（≤65岁）和老年（>65岁）糖尿病患者血糖结果的影响。
总共纳入了英国伯明翰大学医院国民保健服务信托基金Libreview账户注册的2260名成年患者。纳入标准：所有1型和2型糖尿病患者，年龄>18岁，使用isCGM超过6个月，每天扫描至少6次。通过访问电子病历和Libreview收集人口统计学、糖尿病病史和血糖结果（血糖达标时间（TIR）、高于目标范围时间和低于目标范围时间（TBR）、估算糖化血红蛋白、研究开始和结束时的糖化血红蛋白）。对年龄≤65岁或>65岁的年龄组之间的结果进行比较。
大多数患者为白种人（≤65岁组68%，>65岁组73%），患有1型糖尿病。糖尿病平均病程在≤65岁组为19.5年（范围0 - 65年），>65岁组为34.5年（范围0 - 79年）。≤65岁组中只有四分之一（219/943；23.2%）达到其年龄特异性TIR目标，而>65岁组为69%（78/113），同时≤65岁组70.1%（663/946）和>65岁组40.7%（46/113）达到其年龄特异性TBR目标。当应用不太严格的≤65岁组TBR目标时，>65岁组75%（85/113）达到该目标。
FSL的使用与所有年龄组血糖结果改善相关。可能需要个体化目标来改善>65岁人群的TBR。
