Weinstock Ruth S, Raghinaru Dan, Gal Robin L, Bergenstal Richard M, Bradshaw Amy, Cushman Terra, Kollman Craig, Kruger Davida, Johnson Mary L, McArthur Teresa, Olson Beth A, Oser Sean M, Oser Tamara K, Beck Roy W, Hood Korey, Aleppo Grazia
SUNY Upstate Medical University, Syracuse, NY, USA.
Jaeb Center for Health and Research, Tampa, FL, USA.
J Diabetes Sci Technol. 2024 Nov 2:19322968241294250. doi: 10.1177/19322968241294250.
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.
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).
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 = 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 > 0.05). Visit duration was 41 min longer for ages ≥65 versus <40 years ( = 0.001).
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.
老年人可能对持续葡萄糖监测（CGM）技术不太适应，或者需要额外的教育来支持其使用。虚拟糖尿病专科诊所研究提供了一个机会，以了解糖尿病患者中老年人与年轻人使用CGM的血糖结果及所需支持。
对使用基础-餐时胰岛素注射或胰岛素泵治疗的1型糖尿病（T1D，N = 160）或2型糖尿病（T2D，N = 74）成人进行前瞻性虚拟研究。由认证糖尿病护理和教育专家提供远程CGM糖尿病教育（1个月内安排3次就诊），并根据需要增加就诊次数。通过年龄（<40岁、40 - 64岁和≥65岁）评估CGM测量的血糖指标、糖化血红蛋白（HbA1c）和就诊时长。
所有年龄组的CGM中位使用率均≥95%。从基线到6个月，<40岁、40 - 64岁和≥65岁组中血糖在70至180 mg/dL的时间分别从45%±22%改善至57%±16%；从50%±25%改善至65%±18%；从60%±28%改善至69%±18%（<40岁与40 - 64岁组比较，P = 0.006）。HbA1c的相应值分别为8.0%±1.6%至7.3%±1.0%；7.9%±1.6%至7.0%±1.0%；7.4%±1.4%至7.1%±0.9%（均P>0.05）。≥65岁组的就诊时长比<40岁组长41分钟（P = 0.001）。
糖尿病成人在接受远程CGM使用培训后血糖获益，但65岁以上人群的培训时间比年轻人更长。应考虑满足个体与培训相关的需求，包括可能因年龄而异的需求。
