Continuous Glucose Monitoring in Insulin-Treated Older Adults With Diabetes and Alzheimer Disease and Related Dementias
Authors' conclusion
In this cohort study of insulin-treated older adults with ADRD and diabetes, CGM use was associated with improved long-term clinical outcomes. Pragmatic (ie, evaluating the effectiveness of healthcare interventions in everyday settings) trials are needed to validate these findings and to assess the feasibility of CGM use in this population.
Study context
- Population
- Insulin-treated older adults (≥66 years) with and related dementias (ADRD) and DM, Medicare claims 2016–2020; hospice care or professional continuous glucose monitoring (CGM) use excluded; mean age 76.4 years, 56.0% femalematched cohort
- Participants
- 2,022 adults
- Exposure
- Therapeutic CGM use vs prevalent self-monitoring of blood glucose (SMBG) use
- CGMn = 1,011
- SMBGn = 1,011reference
- Outcome
- Hypoglycemia hospitalizations, hyperglycemia crisis and all-cause mortality
Methodological detailsprevalent-new user design, 1:1 propensity score matched (0.25 caliper), nationwide 15% random sample of Medicare claims, negative control outcome, Analysis August 2023 to December 2024
- Prevalent-new user design
- 1:1 propensity score matched (0.25 caliper)
- Nationwide 15% random sample of Medicare claims
- Negative control outcome
- Analysis August 2023 to December 2024
Main finding
As reported in the abstract
Primary outcomes
CGM vs SMBGEstimate (95% CI)
Significantly lower risk
HR (all-cause mortality) 0.57(0.48–0.67)
Primary outcomes
HR (hypoglycemia hospitalization) 0.66(0.40–1.08)
Primary outcomes
HR (hyperglycemia crisis) 1.38(0.99–1.94)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | |
|---|---|---|
| All-cause hospitalizationSignificantly lower risk | 0.86 (0.76–0.96) | |
| Falls | 0.86 (0.68–1.08) | |
| 0.512Hazard ratio (log scale) |
Negative control outcome: upper respiratory tract infections
- No significant differences across analyses
Exploratory subgroup analyses
- Exploratory subgroup analyses showed varied benefits
Original publication
Continuous Glucose Monitoring in Insulin-Treated Older Adults With Diabetes and Alzheimer Disease and Related Dementias. JAMA Netw Open. Published 1 December 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →