1004-P: Remote Initiation of Continuous Glucose Monitoring in Older Adults Using Insulin

Background & Objective: Initiation of continuous glucose monitoring (CGM) remotely in adults with diabetes (DM) has been shown beneficial. However, this model has not been evaluated in older adults. The objective of this study was to assess the benefit and challenges encountered by older patients on multiple daily insulin injections (MDI) initiating CGM using a virtual platform.

Methods: Older adults with DM who are participating in an ongoing study on initiation CGM remotely between January-December 2023 were interviewed. Interviews were transcribed, de-identified, coded, and qualitatively analyzed. Baseline demographic characteristics were collected.

Results: Interim analysis of 24 interviews was conducted: age 72 ± 4 years, duration of diabetes 30 ± 15 years, 52% female, 76% white, 52% having type 1 diabetes (T1DM), 72% CGM naïve, HbA1C 8.1 ± 1.6, 92% on MDI, and 84% utilizing Medicare as primary insurance. Overarching themes were the use of remote education, initiation of CGM remotely, and ongoing use of CGM. All 100% surveyed participants favorably rated the remote education and its ease of scheduling as well as the overall value of CGM. All participants were able to initiate and maintained CGM use successfully with remote education assistance, with 95% of participants planning to continue to use CGM after study completion. The challenges reported with the CGM use included difficulty with mobile application (33%), annoyance with alarms (50%), and concerns for Medicare coverage (42%).

Conclusions: The results of this qualitative analysis show that in our cohort, remote initiation of CGM in older adults was perceived positively, despite some challenges.