Intermittently scanned CGM in older adults with type 2 diabetes not taking insulin: iMMEDIATE post hoc analysis

TL;DR

This study found that using intermittent continuous glucose monitoring with diabetes education improves glucose control in older and younger adults with type 2 diabetes.

Contribution

The study demonstrates that isCGM plus DSME improves TIR in older adults with T2D, a group often excluded from clinical trials.

Findings

Mean TIR improvements were similar across age groups receiving isCGM plus DSME.

Hypoglycemia was rare in both age groups.

Younger adults showed a significant improvement in satisfaction scores with isCGM.

Abstract

In a post hoc analysis of data from the IMMEDIATE study, we compared mean percentage time in range (TIR) in study participants with T2D aged <65 and ≥65 years who were randomized to intermittent subcutaneous continuous glucose monitoring (isCGM) plus diabetes self-management education (DSME) vs DSME alone.

Glucose metrics were analyzed using a linear mixed-effects model, with fixed effects for treatment and age group and random effect for study site. Baseline HbA1c was included as a covariate. Patient-reported outcomes were also evaluated.

The majority of trial participants were aged <65 years, but percentages of adults aged <65 and ≥65 years were similar in the isCGM + DSME and DSME groups. When compared between age groups, mean differences in glycemic outcomes were not statistically significant. Hypoglycemia was infrequent. Among patients aged <65 years, a mean difference of 0.57 (95% CI, 0.38-0.77) in the Glucose Measurement Satisfaction Survey score was observed in participants receiving isCGM + DSME vs DSME; the difference was 0.12 (95% CI, −0.23 to 0.48) in adults aged ≥65 years, with a significant treatment-by-age group interaction (P = .03). No significant treatment-by-age group interactions were observed for the Diabetes Distress Scale or other patient-reported outcomes.

Our findings support the use of isCGM plus DSME to increase TIR in adults with T2D who are not using insulin, independent of age.