Increased access and reimbursement for insulin pumps is critically important for older adults. Recently the Centers for Medicare and Medicaid Services (CMS) issued guidance that the tubeless Omnipod® Insulin Management System (Insulet Corp., Acton, MA) is eligible for coverage under the Medicare Part D (prescription drug) program. This observational study is the first report of glycemic profiles and insulin use in a large cohort of adults aged ≥65 years with diabetes using the Omnipod System and integrated BG meter (Abbott Diabetes Care Inc, Alameda, CA) with a data management system (Glooko, Mountain View, CA). Data uploaded from the pump system to the data management system from January 2015 through September 2018 were matched via device serial number to a second database of self-reported demographic data and de-identified. BG data and insulin use patterns from ≥3 mo of system use per patient were analyzed. Glycemic outcomes included mean glucose, estimated A1C and percent time in range 70-180, <70 and >180 mg/dL. Patients (n=2,313) were mean age 69.7 y (range 65-96 y), 53% female, 23% T1D, 12% T2D, 1% other and 64% not reported. Three percent used CGM for >50% of overall time of system use. Mean glucose was 168±32 mg/dL with an estimated A1C of 7.5%. Percentage time in range 70-180, <70 and >180 mg/dL was 56.8±16.5, 5.3±4.8 and 38.0±17.2, respectively. The total daily insulin was 43.5±22.1 U/d delivered as 55% basal/45% bolus. There was an average of 4.3±1.9 bolus deliveries per day and the average bolus amount was 4.8±3.2 U. These real-world data of a large cohort of Medicare-eligible older adults with diabetes suggest that use of a tubeless insulin pump was associated with glycemic profiles that compare favorably to large national registry data including the T1D Exchange. These results also highlight the importance of access and choice of insulin delivery technology for older adults with diabetes to optimize treatment outcomes.
J.E. Layne: Employee; Self; Insulet Corporation. J. He: Employee; Self; Insulet Corporation. J. Jantz: Employee; Self; Insulet Corporation. Employee; Spouse/Partner; Insulet Corporation. Y. Zheng: Employee; Self; Insulet Corporation. Stock/Shareholder; Self; Insulet Corporation. E. Benjamin: Employee; Self; Insulet Corporation. T.T. Ly: Employee; Self; Insulet Corporation.