Continuous Glucose Monitoring in Older In-patients with Type 2 Diabetes and Cognitive Impairment: A feasibility study

BackgroundType 2 diabetes (T2DM) and cognitive impairment are common long-term chronic conditions affecting older people in hospital. Cognitive impairment can complicate glucose monitoring and lead to diabetes-related emergencies in T2DM. Traditionally, point of care test (POCT) measurements of capillary blood glucose are conducted in-hospital for T2DM while continuous glucose monitoring (CGM) is not widely used. AimTo understand the feasibility, acceptability and tolerability of using CGM in older in-patients with T2DM and cognitive impairment. MethodsThirty-two older people (mean age = 78.7 {+/-}6.7 years) with comorbid T2DM and cognitive impairment (AMT [≤]8/10 and Mini-ACE [≤]22/30) were recruited within a tertiary care hospital in the UK. All participants were naive to CGM and were asked to wear blinded Dexcom G7 sensors for up to 10 days. Participants were asked about feasibility, acceptability and tolerability questions at the point of sensor removal. ResultsTwenty-nine participants (96%) reported no pain during CGM fitting. All participants (100%) agreed that they did not notice wearing the sensor, and it did not affect their day-to-day hospital activities. All participants (100%) found it very easy or easy to have the sensor fitted and wearing it for 10 days, with 27 participants (90%) finding CGM convenient. Seventeen participants (57%) reported favourable perceptions of the subcutaneous sensor sensation. ConclusionCGM use in older in-patients with T2DM and cognitive impairment is highly feasible and acceptable for patients. Future studies and trials are now needed to evaluate the clinical use of CGM for glucose monitoring in hospitalised or community-dwelling older individuals with T2DM and cognitive impairment.