Clin‐ STAR Corner: Practice Changing Advances in Diabetes Care
Year: 2025
Type: review
Study design: Systematic Review
Abstract: BACKGROUND: Diabetes is common among older adults. While most cases are type 2, treatment advances and more adult-onset cases have led to more individuals living with type 1 diabetes. All older adults with diabetes are at an increased risk for hypoglycemia, yet this risk is especially high among those with type 1 diabetes due to the lifelong requirement for insulin. Advanced diabetes technologies-such as continuous glucose monitoring (CGM) and automated insulin delivery systems (AID)-can improve glycemic management, enhance safety, and reduce complications in insulin-requiring individuals. AIMS: We aimed to review randomized controlled trials that tested the feasibility and effectiveness of diabetes technology in older adult populations. METHODS: We conducted a searchfrom 08/15/2024-09/15/2024 that was updated 01/15/2025. We selected six studies testing CGM and AID use in adults ≥ 60 with diabetes, ≥ 3 months follow-up, ≥ 30 participants, and primary glycemic outcomes, prioritizing methodological rigor and clinical relevance. RESULTS: The selected studies demonstrated that CGM reduces hypoglycemia and increases time spent in the target glucose range (70-180 mg/dL) compared to blood glucose monitoring in older adults, with benefits seen across insulin regimens and diabetes types. AID systems reduce both hypoglycemia and hyperglycemia in older adults with type 1 diabetes. Participant adherence and acceptability measures were consistantly high. DISCUSSION: These trials suggest that diabetes technology is feasible to implement in older adult populations and can reduce hypoglycemia without increasing hyperglycemia. CONCLUSIONS: Additional research testing these technologies among populations with age-related impairments is necessary, as are efforts to implement and ensure broad accessibility of these technologies across diverse care settings, including primary and geriatrics care.
DOI: 10.1111/jgs.19595
Authors: Anna R. Kahkoska, Jacob Ortega, Anika Bilal, Richard E. Pratley
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,760
Awards: G1908040713, G3069299928, G4254874663, The role of type 2 diabetes on skeletal muscle atrophy and recovery following bed rest in older adults, Diabetes RElated to Acute Pancreatitis and its Mechanisms: Metabolic Outcomes Using Novel CGM Metrics (DREAM-ON), Clin-STAR Coordinating Center, Building a Real-World Evidence Base for Continuous Glucose Monitoring in Older Adults with Diabetes, Data Coordinating Center for the Type 1 Diabetes in Acute Pancreatitis Consortium, Continuation of Type 1 Diabetes in Acute Pancreatitis Consortium – UF Health and AdventHealth Combined Clinical Center
OpenAlex ID: W4412364505