Date of Award

8-12-2021

Document Type

Open Access Thesis

Degree Name

MS in Physician Assistant Studies (PA)

Department

Physician Assistant Studies

First Advisor

Kari Bernard, PhD, PA-C

Abstract

Introduction: Type 1 diabetes (T1D) impacts many individuals around the world. Treatment goals of T1D include lowering hemoglobin A1c (HbA1c) values while minimizing the time spent in hypoglycemia. Frequent glucose monitoring is required to achieve optimal glycemic control.

Background: HbA1c has been used for many years to track glycemic control. When discussing care of older adults, hypoglycemia is a more important marker to track. The risks associated with hypoglycemia are higher among older adults with T1D than the general population. Multimorbidity, polypharmacy, and age-related mental decline increase the likelihood and danger of severe hypoglycemic episodes. Self-monitoring blood glucose (SMBG) provides point-in-time glucose measurements. Continuous glucose monitors (CGM) are wearable devices that transmit continuous glucose measurements throughout the day. Variations in glucose are viewed in real time, and users can be alerted when glucose levels are dangerously high or low. Methods: A literature search was completed to assess the benefits of CGM use in older adults. The PubMed database was used to identify relevant articles.

Discussion: CGM devices show greater improvements in HbA1c and greater reductions in hypoglycemia over SMBG. Health-related quality of life is also seen to increase with use. Given the significant effects of CGM use on hypoglycemia, the devices should be recommended for use in all older adults with T1D.

Conclusion: Further research is needed to evaluate the benefits of CGM use in various subpopulations of older adults. Reasons for limited use in this population should also be explored with the goal of increasing accessibility and usability.

Identifier

SC 11.PAS.2021.Clements.A

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