Objective: Integrative diabetes care encompasses Patient Reported Outcome Measures (PROMs); instruments to measure patients’ perceptions of treatment options. In T1D and T2D patients with well controlled diabetes on MDI, introduction of new means of glucose monitoring (e.g., CGM) should not impose additional psychological burden regardless supposed added benefit in glucose control. The aim of present study was to investigate CGM as a tool for optimizing and personalizing treatment goals in elderly.
Methods: Elderly patients (n=25, age 67±6 years, HbA1c=7.1±0.7%) treated with MDI were instructed to use a CGM device. Blinded CGM was followed by real-time CGM use. Glycemic control metrics (time in range (TIR), glycemic variability expressed by Coefficient of Variation (CV)) were compared by paired samples T-test. PROMs were measured by questionnaires.
Results: Significant improvements in TIR (3.9 - 10.0 mmol/L) (66,3±12,4% vs. 76,9±14,1%; p<0.05), as well as reduced glycemic variability (%CV) (37.3±11.1 vs. 32.9±6.3; p<0.05) were observed. Satisfaction with CGM use was high; every patient (100%) reported that CGM use was overall positive and helpful, with perceived advantages as very common (average grading 4.22 out of 5) and annoyances as modest (1.82 out of 5). Majority (95%) of participants expressed improved sense of security with CGM use, 68% reported of improved sleep quality and 82% were willing to use a CGM device after having finished the study protocol. CGM introduction did not impose additional diabetes related distress (no significant difference in PAID Questionnaire score after intervention).
Conclusion: Introduction of CGM use in well controlled diabetes patients on MDI results in more stable glycemia and more time spent in target range; without additional diabetes treatment related emotional burden detected. Despite confronted with novel diabetes technology, the elderly reported of positive subjective outcomes and were keen to adopt CGM.
S. Volcansek: None. M. Lunder: None. A. Janez: None.
