Diabetes Technology and the Older Adult: Clinical Outcomes and Implementation Strategies

The prevalence of diabetes among older adults continues to rise. Aging brings unique challenges to the management of diabetes in older adults, as treatment goals and patients' ability to reach those goals depend on overall health status and support systems, which can change frequently in this population. In addition, hypoglycemia has severe consequences in the older population and remains a limiting factor in our ability to improve glycemic control. Recent advancements in diabetes technology-such as smart insulin pens, continuous glucose monitoring, and hybrid closed-loop insulin pump systems-offer improved glycemic control and reduced risk of hypoglycemia in all adults, although available evidence often excludes older adults with frailty or cognitive impairment. Recent studies of technology use in relatively healthy older adults have demonstrated benefits, including higher time in range, less severe hypoglycemia, and enhanced satisfaction. Careful patient selection, comprehensive education, and caregiver support are crucial to the successful use of technology by older adults with diabetes. By applying a geriatric-focused approach, which balances modern technology with the individual's functional status, cognition, and comorbidities, clinicians can optimize safety and efficacy in managing diabetes in older adults. This approach should be applied regardless of diabetes type or the patient's degree of frailty.