Intermittent Glucose Monitoring Significantly Improves Long-Term Blood Sugar Control in Older Adults with Diabetes: Study

While real-time CGM systems have already shown promise in older populations, evidence around is-CGM—a less costly and more accessible alternative—has remained limited. To address this gap, the Dutch research team conducted a retrospective case–control study, analyzing data from 353 individuals drawn from their outpatient diabetes clinic between 2015 and 2022.

Among the participants, 142 individuals who initiated is-CGM were matched with 211 control patients who did not use CGM, with matching based on age, sex, diabetes type, and insulin delivery method (pen or pump). The team tracked hemoglobin A1c (HbA1c) levels across several time points—baseline, 3, 6, 9, 12, and 24 months after initiating is-CGM—to determine the technology’s impact on glycemic control.

The study revealed the following findings:

• Findings showed a consistent and sustained improvement in blood sugar control among is-CGM users.
• At three months after starting is-CGM, HbA1c levels dropped significantly more in users compared to the control group (−0.50% vs. −0.01%).
• The HbA1c reductions remained statistically significant at 6 months (−0.46%;) and 24 months (−0.39%), even after adjusting for confounders.
• Baseline HbA1c levels were similar between both groups—7.9% in is-CGM users and 7.8% in controls—indicating that the benefits were not due to differences at the start.
• Adherence to is-CGM was high, with only 2.8% of users discontinuing due to device-related issues.
• No diabetes-related complications were reported in either group during the study period, supporting the safety of is-CGM in older adults.

“This data supports the use of is-CGM among older adults with diabetes, particularly given the low rate of discontinuation and the meaningful reductions in HbA1c,” Dr. Been and colleagues noted. They also suggested that additional education and support may help the small proportion of users who discontinue the device to resume usage successfully.

Despite its strengths, the researchers noted that the study had some limitations. There was an imbalance in the number of type 1 diabetes patients between the two groups, and individuals aged 80 and above were underrepresented. Furthermore, the single-centre design at an academic hospital may limit the broader applicability of the results.

"Still, the study adds valuable evidence supporting the integration of is-CGM in diabetes management strategies for older populations, offering a sustainable and user-friendly tool to enhance long-term glucose control," they concluded.

Reference:

Been RA, van Helsdingen MRX, Zammit D, Grzegorczyk M, Krijnen WP, Tamasi K, Gans ROB, van Beek AP, van Dijk PR. The efficacy of intermittent scanning continuous glucose monitoring in the elderly: A case-control study. Diabetes Obes Metab. 2025 May 13. doi: 10.1111/dom.16417. Epub ahead of print. PMID: 40357716.