Glycemic Control Utilizing Continuous Glucose Monitoring vs. Point-of-Care Testing in Older Adults with Type 2 Diabetes in Long-Term Care Facilities

We compared the efficacy of continuous glucose monitoring (CGM) and point of care (POC) testing (standard of care) in assessing glycemic control in older adults with T2D treated with either basal insulin or insulin secretagogues plus sliding scale in long-term care facilities (LTCF). All 97 subjects underwent POC testing before meals and bedtime and wore a Dexcom CGM. Treatment adjustment was performed by the primary care team, with a target glucose of 140-180 mg/dL, and for a duration of intervention up to 60 days. Study endpoints included differences in hypoglycemia < 70 and 54 mg/dL and hyperglycemia > 180 and 250 mg/dL by POC and CGM. Participants baseline characteristics (age: 74.7±11 years, BMI: 29.6±7.9, HbA1c: 8.06±2.2%) admitted to skilled nursing care/subacute rehab (80%) or long-term care (20%) facilities with a median length of participation of 17 (interquartile range 11, 29) days. The mean daily glucose by POC was lower than CGM (171±45 vs. 188±45 mg/dL, p<0.01). CGM detected significant greater proportions of subjects with hypoglycemia <70 mg/dL (40% vs. 14%) and <54 mg/dL (21% vs. 1.0%); as well as hyperglycemia >250 mg/dL (77% vs. 56%) compared to POC testing, all p<0.001. Conclusion: In older adults with T2D admitted to long-term care facilities, the use of CGM significantly improved detection of hypoglycemic and hyperglycemic events compared to POC. Disclosure T.Idrees: None. T.M.Johnson: Consultant; Astellas Pharma Inc., Research Support; Dexcom, Inc. L.Peng: None. G.Umpierrez: Research Support; Abbott, Dexcom, Inc., Baxter. I.A.Castro-revoredo: None. M.D.Gavaller: None. H.Oh: None. Z.Zabala: None. E.M.Moreno: None. B.Moazzami: None. R.J.Galindo: Consultant; Novo Nordisk, Eli Lilly and Company, Sanofi, Pfizer Inc., Bayer Inc., WW (Weight Watchers), Research Support; Novo Nordisk, Eli Lilly and Company, Dexcom, Inc. E.Cabb: None. Funding Dexcom, Inc. (IIS-2020-119_6X)