964-P: CGM-Tele Monitoring in Older Adults with T1D: Results of a Pilot Study

T1D management in older individuals can be difficult due to an increased risk for hypoglycemia and other co-morbidities. CGM can help lower rates of hypoglycemia; however, in practice, patient data is only reviewed at clinic visits, rather than in near real-time by the diabetes care team. This pilot study tested if patients could be remotely monitored daily through a CGM system (Dexcom G5/6) that communicated via smart phone to a Tidepool designed dashboard. Alerts were set for: ≥4 hours without CGM signal, ≥2 hours 54-70 mg/dl, and 15 mins <54 mg/dl. If alerts occurred, the CDE performed telemedicine outreach following a protocol. Ten individuals with T1D ≥65 years were enrolled. Patients were 72+5.3 years; duration of diabetes 39.1+16.5 years; 50% were on CSII. At baseline, the CGM was connected to the monitoring system, followed by 2 weeks of system checks. Remote monitoring was activated at week 2 continuing to week 14. Three patients didn’t complete the study. One had connection issues, one didn't want to wear the CGM; the third had spousal health issues. The CDE/system was capable of identifying the desired findings (Table). An A1C was measured at baseline and 14 weeks. The A1C didn’t change, 7.2% +0.95 vs. 7.3% +0.99. This trial proved it was possible to monitor well-controlled seniors with T1D using an automated system with daily alerts to identify episodes of hypoglycemia and time off CGM. Further research is needed to assess the alert system efficacy.