Glucose Monitoring and Control on Health Outcomes in Older Adults for Type 1 Diabetes

Reducing hypoglycemia in older adults with type 1 diabetes

By Joslin Tango

Adults using insulin for type 1 diabetes have an increased risk of severe hypoglycemia with advanced age, but their use of continuous glucose monitoring (CGM) technology has not been studied. RTI experts are engaging in ways to better understand the effectiveness of CGM in reducing hypoglycemia and improving costs.

Technological Advances in Glucose Management in Older Adults (the Tango Study, 2016 to date), is a randomized controlled trial conducted at the Joslin Diabetes Center in Boston, Massachusetts, to determine whether enhanced CGM can reduce hypoglycemia in adults over age 65 with type 1 diabetes.

Older adults who use insulin have a heightened risk of hypoglycemia due to cognitive decline (e.g., forgetfulness or dementia), loss of symptoms that alert the individual (i.e., hypoglycemia unawareness), and comorbid conditions (other than diabetes). This study combines technologies used in other populations (such as CGM, Bluetooth insulin pumps or pens, a Bluetooth glucometer, and Fitbit activity tracker) that can monitor and predict hypoglycemia, thereby reducing the risk of a safety event.

RTI experts are performing a qualitative assessment and an economic analysis using interviews and surveys to identify enablers and barriers to technology use and medical utilization to understand the cost-utility and cost-effectiveness of enhanced CGM at reducing hypoglycemia risk. RTI tested a technology “platform” that includes CGM combined with clinical decision support to reduce the risk of hypoglycemia.

Participant recruitment is from 2017-2020. Learn more about the clinical trial.