Glucose Patterns in Very Old Adults: A Pilot Study in a Community-Based Population
Year: 2021
Type: article
Study design: Observational Study
Abstract: Context: Continuous glucose monitoring (CGM) provides nuanced information on glucose patterns, but data in very old adults are scarce. Objective: To evaluate CGM patterns in very old adults. Design: Pilot study. Setting: Participants recruited from one center during visit 7 (2019) of the community-based Atherosclerosis Risk in Communities (ARIC) Study. Participants: We enrolled 27 adults (8 with type 2 diabetes and 19 without diabetes) who wore a CGM sensor (Abbott Libre Pro) for up to 14 days. Clinical and laboratory measures, including hemoglobin A1c (HbA1c), were obtained. Main Outcomes: Mean CGM glucose, standard deviation (SD), coefficient of variation (CV), time-in-range (TIR) 70–180 mg/dL, and hypoglycemia. Results: Mean age was 81 (range 77–91 years) and mean CGM wear time was 13.2 days. In persons without diabetes, there was a wide range of CGM parameters: range of mean glucose, 83.7–124.5 mg/dL, SD 12.2–27.3 mg/dL, CV 14.0%–26.7%, and TIR 71.1%–99.5%. In persons with diabetes, the range of mean CGM glucose was 105.5–223.0 mg/dL, SD, 22.3–86.6 mg/dL, CV 18.2%–38.8%, TIR 38.7%–98.3%. The Pearson's correlation of mean glucose with HbA1c was high overall (0.90); but, for some participants with similar HbA1c, glucose patterns differed substantially. There was a high prevalence of hypoglycemia (glucose <70 or <54 mg/dL) in both persons with and without diabetes. Conclusions: There was high feasibility and acceptability of CGM in very old adults. Low readings on CGM are common, even in nondiabetic older adults; the clinical relevance of these low values is unclear. CGM may provide complementary information to HbA1c in some older adults.
Institutions: Johns Hopkins University, Johns Hopkins Medicine
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1114307781, Glucose instability and neurocognitive outcomes in older adults, Research and Mentoring in the Clinical Epidemiology of Cardiovascular Disease and Type 2 Diabetes, G3973572274, G4790942633, Establishing the Pathways Between Diabetes and Cardiac Dysfunction: Epidemiology, Biomarkers, and Imaging, Research and Mentoring in the Clinical Epidemiology of Type 2 Diabetes, G5770678025, Racial disparities in diabetes- and prediabetes-associated outcomes in older adults, Diabetes and Prediabetes in Older Adults in ARIC, G6837735701, Glucose patterns and cardiac arrhythmias in older adults with diabetes, Cardiovascular Epidemiology Institutional Training, Clinical relevance of glucose patterns in older adults
OpenAlex ID: W3173326597