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Continuous glucose monitoring in older adults with type 1 and type 2 diabetes using multiple daily injections of insulin: results from the DIAMOND trial

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Ruedy, Katrina J., Parkin, Christopher G., Riddlesworth, Tonya D., Graham, Claudia·2017·Journal of Diabetes Science and Technology
DOI 10.1177/1932296817704445PMC PMC5951040
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Abstract

Objective The objective was to determine the effectiveness of real-time continuous glucose monitoring (CGM) in adults ≥ 60 years of age with type 1 (T1D) or type 2 (T2D) diabetes using multiple daily insulin injections (MDI). Methods A multicenter, randomized trial was conducted in the United States and Canada in which 116 individuals ≥60 years (mean 67 ± 5 years) with T1D (n = 34) or T2D (n = 82) using MDI therapy were randomly assigned to either CGM (Dexcom™ G4 Platinum CGM System® with software 505; n = 63) or continued management with self-monitoring blood glucose (SMBG; n = 53). Median diabetes duration was 21 (14, 30) years and mean baseline HbA1c was 8.5 ± 0.6%. The primary outcome, HbA1c at 24 weeks, was obtained for 114 (98%) participants. Results HbA1c reduction from baseline to 24 weeks was greater in the CGM group than Control group (-0.9 ± 0.7% versus -0.5 ± 0.7%, adjusted difference in mean change was -0.4 ± 0.1%, P 250 mg/dL ( P = .006) and glycemic variability ( P = .02) were lower in the CGM group. Among the 61 in the CGM group completing the trial, 97% used CGM ≥ 6 days/week in month 6. There were no severe hypoglycemic or diabetic ketoacidosis events in either group. Conclusion In adults ≥ 60 years of age with T1D and T2D using MDI, CGM use was high and associated with improved HbA1c and reduced glycemic variability. Therefore, CGM should be considered for older adults with diabetes using MDI.

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  • The DIAMOND study demonstrated that in adults over 60 years of age with either type 1 or type 2 diabetes using multiple daily injections, continuous glucose monitoring use was associated with improved A1C and reduced glycemic variability.

    “The DIAMOND (Multiple Daily Injections and Continuous Glucose Monitoring in Diabetes) study demonstrated that in adults $60 years of age with either type 1 or type 2 diabetes using multiple daily injections, CGM use was associated with improved A1C and reduced glycemic variability (43).”

    From 13. Older Adults: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [43]

  • CGM is approved for use by Medicare and can play a critical role in improving A1C, reducing glycemic variability, and reducing risk of hypoglycemia.

    “CGM is approved for use by Medicare and can play a critical role in improving A1C, reducing glycemic variability, and reducing risk of hypoglycemia (43)”

    From 13. Older Adults: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [43]

  • The DIAMOND study demonstrated that in adults ≥60 years of age with either type 1 or type 2 diabetes using multiple daily injections of insulin, CGM use was associated with improved A1C and reduced glycemic variability.

    “The DIAMOND (Multiple Daily Injections and Continuous Glucose Monitoring in Diabetes) study demonstrated that in adults $60 years of age with either type 1 or type 2 diabetes using multiple daily injections of insulin, CGM use was associated with improved A1C and reduced glycemic variability (45).”

    From 13. Older Adults: Standards of Care in Diabetes—2025 (2025) · cites this paper as [45]

  • CGM is approved for use by Medicare and can play a critical role in improving A1C, reducing glycemic variability, and reducing risk of hypoglycemia.

    “CGM is approved for use by Medicare and can play a critical role in improving A1C, reducing glycemic variability, and reducing risk of hypoglycemia (45)”

    From 13. Older Adults: Standards of Care in Diabetes—2025 (2025) · cites this paper as [45]

  • CGM devices have been shown to be effective at improving glycemic management.

    “Continuous glucose monitoring (CGM) devices have been shown to be effective at improving glycemic management and acceptable to people of all age-groups, including older individuals with type 1 diabetes (44–48) or insulin-requiring type 2 diabetes (49,50).”

    From 13. Older Adults: Standards of Care in Diabetes—2026 (2026) · cites this paper as [49]

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Authors
Ruedy, K. J., Parkin, C. G., Riddlesworth, T. D., & Graham, C.
Affiliations
  • Jaeb Center for Health Research (US)
  • CGParkin Communications, Inc, Boulder City, NV, USA
  • Dexcom (United States) (US)
Corresponding author
Graham, Claudia
ORCID
Venue
Journal of Diabetes Science and Technology
Publisher
SAGE Publications
Published
2017-04-28
Volume
11
Issue
6
Pages
1138-1146
ISSN
1932-2968 (ISSN-L)
DOI
10.1177/1932296817704445
PMC
PMC5951040
OpenAlex
W2607894511
Cited by
225
References
10
Citations by year
2026: 25 · 2025: 30 · 2024: 26 · 2023: 33 · 2022: 33 · 2021: 27 · 2020: 21 · 2019: 15 · 2018: 11 · 2017: 4
FWCI
11.02
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Journal of Diabetes Science and Technology (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
Dexcom, Inc.
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords
continuous glucose monitoring, older adults, type 1 diabetes, type 2 diabetes, multiple daily insulin injections, HbA1c, glycemic variability, self-monitoring of blood glucose, hypoglycemia, diabetic ketoacidosis
MeSH terms
Aged, Blood Glucose, Canada, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Drug Administration Schedule, Female, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Injections, Insulin, Male, Middle Aged, Predictive Value of Tests, Time Factors, United States, Blood Glucose Self-Monitoring, Reproducibility of Results, Biomarkers, Treatment Outcome, Monitoring, Ambulatory

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