Introduction & Objective: The use of continuous glucose monitoring (CGM) devices improves glycemic outcomes and minimizes hypoglycemia in older adults with diabetes. Herein, we assessed the temporal trends and characteristics of CGM initiation in this population.
Methods: Using Medicare fee-for-service data (2013-19), we identified two cohorts of patients aged ≥65 years with type 2 and type 1 diabetes and estimated the annual proportion of CGM initiation. In each cohort, we 1:4 matched new users of CGM to patients unexposed to CGM, using risk set sampling. Index date was the date of CGM initiation or, for controls, the closest physician visit within +/-7 days. We used logistic regression to assess patient characteristics associated with CGM initiation.
Results: The annual proportion of CGM initiators increased from 7 to 33/100,000 patients with type 2 diabetes and from 111 to 393/100,000 patients with type 1 diabetes. Low frailty and white race were associated with higher odds of CGM initiation in both cohorts. CGM initiators with type 2 diabetes were more likely to have history of hypoglycemia, and to be on insulin, glucagon-like peptide 1 receptor agonists, or sulfonylureas.
Conclusion: CGM initiation has significantly increased over time among older adults with type 2 and type 1 diabetes; however racial and ethnic disparities were observed.
W. Alkabbani: None. J.M. Paik: None. D.H. Kim: None. M. Munshi: Consultant; Sanofi. D.J. Wexler: Other Relationship; Novo Nordisk. E. Patorno: Research Support; Boehringer-Ingelheim, Food and Drug Administration (FDA), National Institutes of Health, Patient-Centered Outcomes Research Institute.
