The efficacy of intermittent scanning continuous glucose monitoring in the elderly: A case-control study

The efficacy of intermittently scanning continuous glucose monitoring (is-CGM) technology among elderly people with diabetes mellitus (DM) has been understudied. We investigated if the initiation of is-CGM results in improved glycemic control among this population.

Retrospective, observational case-control study. Cases were selected randomly from the DM outpatient clinic of the University Medical Center Groningen between 2015 and 2022 if they had type 1 or type 2 DM, were registered users of is-CGM devices and were aged 60 or older at initiation of those devices. They were matched to randomly selected controls with no CGM usage based on age, gender, DM type and treatment type (insulin-pen or pump). Data were collected at baseline, 6 months prior and 3, 6, 9, 12 and 24 months after initiation. Linear mixed-effects regression was performed to assess the effects of is-CGM usage on HbA1c.

Three hundred and fifty-three participants were analysed (142 cases, 211 controls). Median HbA1c at baseline for is-CGM users was 8.00% [7.20%-9.10%] and for controls 7.90% [7.10%-8.70%]. Unadjusted analysis showed significant reductions of HbA1c 3 months after initialization (cases vs. controls, -0.50% vs. -0.02%, p = 0.016), persisting throughout the study. Adjusting for confounders, is-CGM initiation resulted in significant HbA1c reductions after 6 months (-0.29%, p = 0.006) up until 24 months (-0.39%, p = 0.033). The rate of sensor discontinuation was 2.8%.

The use of is-CGM improves glycemic control in elderly (≥60 years old) persons with DM after 3 months, and this persists for at least 24 months. The number of discontinuations is low. This data emphasizes the positive impact of is-CGM on the elderly population with DM.