1026-P: Sustained Benefits of Continuous Glucose Monitoring Combined with Geriatric Principles in Reducing Hypoglycemia at 12 Months in Older Adults with Type 1 Diabetes

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Introduction and Objective: In our previous study entitled “Technological Advances in Glucose Management in Older Adults [TANGO]” (NCT03078491), we have shown that CGM use enhanced by geriatric principles (eCGM) in older adults with type 1 diabetes (T1D) lowers hypoglycemia (<70 mg/dL) without worsening glycemic control, compared to control group receiving usual care, at 6-months (PMID: 39325586). The aim of this study is to evaluate whether the benefits of eCGM are sustained during the observational extension phase. Methods: Older adults with T1D (≥65 years old) with hypoglycemia, either CGM naïve or CGM users, who completed the 6 month intervention phase, were assessed at 12 months. The primary endpoint was change in duration <70 mg/dL. Secondary outcomes included changes in other CGM metrics and HbA1c from 6 to 12 months. Results: Out of 48 participants in the intervention arm at 6 months, 90% (n=43) completed the 12 month assessment. Between 6 and 12 months, there was no change in median duration of hypoglycemia (<70 mg/dL) (1.34 (IQR 1.6) vs 1.1 (IQR 2.2) %; p=0.4), mean glucose (171 ± 22 vs 168 ± 26 mg/dL; p=0.1), coefficient of variation (0.35 ± 0.06 vs 0.35 ± 0.07%; p=0.5) and HbA1c (7.5 ± 0.8% vs 7.5 ± 0.9%; p=0.7), while time-in-range improved (57% vs 62%; p <0.001). There were no differences in these measures when the group was stratified by CGM use at baseline (naïve vs. user). Conclusion: In older adults with T1D and hypoglycemia, benefits of CGM use, combined with geriatric principles, were sustained after observational extension phase, independent of the status of CGM use at baseline. Disclosure E. Toschi: Consultant; Vertex Pharmaceuticals Incorporated, Sequel Med Tech. Research Support; Dexcom, Inc. C. Slyne: None. M. Savory: None. S. Kasetti: None. H. Brabant: None. N. Krakoff: None. A. Adam: None. M. Munshi: Advisory Panel; Abbott, Medtronic. Research Support; Dexcom, Inc. Advisory Panel; Sanofi. Funding This study was supported by theNational Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (grant DP3DK112214 to M.N.M. and E.T.). CGM materials were partially suppliedby Dexcom.

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