Continuous glucose monitoring in older people with diabetes receiving home care—a feasibility study
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Abstract
BACKGROUND: Hypoglycemic incidents in older people can cause severe health problems, enhance general age-related disabilities, and cause frailty. Little is known about incidences of hypoglycemia in older home-dwelling people with diabetes. Thus, the aim of this study was to examine the feasibility of capturing hypoglycemia and issues associated with increased risk of hypoglycemia by use of continuous glucose monitoring (CGM) and standardized questionnaires among older home-dwelling individuals with diabetes type 2 receiving home care. METHODS: CGM with the Ipro2-blinded monitoring system were performed for 5 days in six home-dwelling individuals ≥ 75 years diagnosed with diabetes and receiving home care. Demographic (age, gender, living arrangements) and clinical data (diabetes diagnoses and duration, diabetes medication, documented treatment goal, available glycosylated hemoglobin (HbA1c)) were collected from electronic patient records in home care services. Feasibility (ease of use, quality of data, time spent) of standardized questionnaires to identify the risk of hypoglycemia (the McKellar Risk Assessment Tool), risk of malnutrition (the Mini Nutritional Assessment (MNA)), functional status (the Individual-based Statistics for Nursing and Care Services (IPLOS)), and cognitive status (the Mini Mental Status Exam (MMSE)) was also assessed. Questionnaire data was collected by a study nurse in the individuals' home. RESULTS: The practical use of CGM was satisfactory, with no major remarks about discomfort or technical errors, except for one participant with skin reaction (redness). Collecting data with the McKellar Risk Assessment Tool, MNA and IPLOS worked well according to quality of data, time spent, and ease of use. The MMSE survey required extensive training of personnel to be conducted. CONCLUSION: The feasibility study informs an upcoming study on the incidence and risk factors of hypoglycemia in home-dwelling older individuals. We will ascertain that personnel who will use the MMSE questionnaire to collect cognitive status and skills are familiar with the tool and adequately educated and trained before study start. The use of blinded CGM in this population was well tolerated and can be used "as is" for future studies.
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A feasibility study in LTC facilities showed that CGM can be useful in older adults with diabetes, although it requires substantial staff training.
“Nevertheless, a feasibility study in LTC facilities showed that CGM can be useful in older adults with diabetes, although it requires substantial staff training (140).”
From 13. Older Adults: Standards of Care in Diabetes—2025 (2025) · cites this paper as [140]
The Results (Feasibility of CGM) and Discussion support that CGM was feasible and useful for detecting hypoglycemia in older adults with diabetes receiving home care, not in long-term care facilities. The Abstract Results and Key messages say extensive training was needed for personnel administering the MMSE questionnaire, not for CGM; they describe personnel effort as reasonable. (LLM, conf=0.91)
Experimental — accuracy not yet measuredA feasibility study in PALTC facilities showed that CGM can be useful in older adults with diabetes, although it requires substantial staff training.
“Nevertheless, a feasibility study in PALTC facilities showed that CGM can be useful in older adults with diabetes, although it requires substantial staff training (158).”
From 13. Older Adults: Standards of Care in Diabetes—2026 (2026) · cites this paper as [158]
The Results (Feasibility of CGM) and Discussion say CGM was feasible and useful for detecting hypoglycemia in older people receiving home care. The study was not conducted in PALTC facilities. The Abstract (Results) attributes extensive personnel training to the MMSE survey, not CGM; the Discussion mentions CGM training as an issue to address but does not say it requires substantial training. (LLM, conf=0.90)
Experimental — accuracy not yet measured
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Cites
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Cited by
Sorted by citations
13. Older Adults: Standards of Care in Diabetes—2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Echouffo-Tcheugui, J. B., Ekhlaspour, L., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s013 · Cited by 209 · see citing works
13. Older Adults: Standards of Care in Diabetes—2026
American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., et al. (2026) · Diabetes Care · doi:10.2337/dc26-s013 · Cited by 87 · see citing works
Idrees, T., Castro-Revoredo, I. A., Oh, H. D., Gavaller, M. D., Zabala, Z., Moreno, E., Moazzami, B., Galindo, R. J., Vellanki, P., Cabb, E., et al. (2024) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2024.01.031 · Cited by 22 · see citing works
Fløde, M., Hermann, M., Haugstvedt, A., Søfteland, E., Igland, J., Åsberg, A., Jenssen, T. G., & Graue, M. (2023) · BMC Endocrine Disorders · doi:10.1186/s12902-023-01472-6 · Cited by 15 · see citing works
Self-citation
- Authors
- Larsen, A. B., Hermann, M., & Graue, M.
- Affiliations
- Western Norway University of Applied Sciences (NO)
- Corresponding author
- Graue, Marit
- Venue
- Pilot and Feasibility Studies
- Published
- 2021-01-06
- Volume
- 7
- Issue
- 1
- Pages
- 12-12
- ISSN
- 2055-5784 (ISSN-L)
- PMC
- PMC7786485
- OpenAlex
- W3108595291
- Cited by
- 19
- References
- 2
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 4 · 2023: 2 · 2022: 5
- FWCI
- 2.05
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Pilot and Feasibility Studies (publishedVersion, cc-by)
- Research Square (acceptedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Diabetesforbundet (None)
- 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, hypoglycemia, older adults, type 2 diabetes, home care, community-dwelling older adults, feasibility, Mini Nutritional Assessment, functional status, cognitive status, Mini-Mental State Examination, frailty, malnutrition risk
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