Introduction and Objective: Elderly individuals with diabetes are less likely to be offered continuous glucose monitoring (CGM), as they are often perceived as having difficulties using this technology. We conducted a retrospective observational study to assess the use of CGM in patients with diabetes aged ≥70 years.Methods: Patients aged ≥70 years with diabetes treated with intensive insulin therapy (IIT), hospitalized due to poor glycemic control, who started CGM (FreeStyle Libre 2) at discharge after CGM-oriented education, were included. CGM data were analyzed after an average follow-up of one year.Results: Fifty-eight inpatients (mean [±SD] age 74.4±3.9 years; range 70-87 years; 21 women) with type 1 (n=10), type 2 (n=39), or diabetes associated with chronic pancreatitis (n=9), with diabetes duration of 20.2±14 years (range 1-50 years) and eGFR at admission of 60.9±20.4 ml/min/1.73 m², were included. Continuous intravenous insulin infusion and non-insulin antihyperglycemic agents were used during hospitalization. Mean HbA1c at admission was 9.39±2.92% (5.3-20.5%) and decreased to 7.36±0.86% (6.6-9.7%) after 11.6±8.3 months of continuing IIT and CGM use (p<0.001). At the end of follow-up, time in range (TIR), time below range (<70 mg/dl; TBR), and time above range (>180 mg/dl; TAR) were 64.5±23.5%, 1.5±3.0%, and 34.0±23.6%, respectively. The coefficient of variation (CV) was 30.3±9.4%, sensor activity time 89±16%, number of daily scans 50.2±133.6 (range 2-951), and number of hypoglycemic episodes 0.2±0.3/day (0-1.3). No association was observed between age or diabetes duration and TIR, TBR, TAR, baseline HbA1c, or sensor activity time. A positive correlation was found between diabetes duration and CV (r=0.42), as well as between CV and TBR (r=0.71) and the number of hypoglycemic episodes (r=0.73; all p<0.05).Conclusion: CGM should be recommended for patients aged ≥70 years treated with IIT, particularly those with longer diabetes duration, who are at increased risk of hypoglycemia.
M. Zarytowska: None. L. Czupryniak: Speaker’s Bureau; Current; Abbott. Advisory Panel; Current; Abbott. Research Support; Current; Abbott.
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