Are glucose monitoring devices suitable for older adults with memory problems?

Takeaway

• Older adults with diabetes mellitus (DM) and memory impairment can operate a continuous glucose monitoring (CGM) device that requires manual scanning, but CGMs with real-time transmission might be preferable.

Study design

• Freestyle Libre device used for 14 days by 12 community-dwelling adults aged ≥65 (mean age, 85) years with diabetes (11 type 2; 9 using insulin) and abbreviated mental test score ≤8 or known dementia (n=3).
• Libre users must scan sensor, worn on upper arm, at least every 8 hours or additional data are lost.
• Funding:Alzheimer’s Society, McKesson.

Key results

• Data capture ranged between 3% and 92% (mean 55%), with <60% in 6 participants.
• CGM detected hypoglycaemic events in 6 of 9 insulin users, average duration 106-437 minutes.
• Participants and carers found the device acceptable, with most reporting that it did not interfere with activities.
• Most common advantage of device named by participants was elimination of finger-pricking.
• Carers reported finding the device reassuring, and safer than fingersticks for checking glucose levels.

Limitations

• Short duration.
• Libre known to be less accurate at glucose extremes.