"AID Systems Improve Diabetes Care for Older Adults"

Recent research led by Washington State University in collaboration with multiple institutions has highlighted the effectiveness and safety of automated insulin delivery (AID) systems for older adults with type 1 diabetes. Published in NEJM Evidence, this study challenges the preconceived notion that older individuals may struggle with advanced technological devices that manage diabetes.

Understanding Automated Insulin Delivery Systems

An AID system consists of a glucose sensor that is attached to the user's body, which continuously monitors blood glucose levels. This sensor communicates data to a wearable insulin pump, allowing it to automatically adjust insulin doses without any manual input from the user. Some advanced models even connect wirelessly to smartphones, providing real-time updates on blood sugar control.

Challenging Stereotypes

"It's a significant change for individuals accustomed to managing their diabetes with injections over many years," stated Professor Naomi Chaytor, a co-author of the study and chair of the Department of Community and Behavioral Health at WSU. "There's a stereotype that older adults find technology more difficult to navigate, but our findings show that they adapted well to these new systems."

Key Findings from the Study

This study represents the largest clinical trial focused on older adults with type 1 diabetes and illustrates the potential benefits of AID systems for this demographic, which has been largely unrepresented in previous studies. The trial specifically examined:

• Usability of technology among older patients.
• Prevention of hypoglycemia, which is particularly concerning for older individuals due to potential cognitive decline and increased risk of falls.

Trial Methodology

The study tested two AID systems in a randomized crossover trial involving 78 participants aged 65 and older. The devices evaluated included:

Each participant used both AID systems and a traditional sensor-augmented pump system for 12 weeks.

Results and Implications

The results were promising, demonstrating that both AID systems significantly reduced the amount of time participants spent with dangerously low blood sugar levels compared to the traditional system. The hybrid closed loop system emerged as the most effective, achieving a mean time in the target blood sugar range of 74%, compared to 67% for the predictive low glucose system and 66% for the sensor-augmented system.

However, the initial adoption of AID systems required more technical support and training for older participants. Despite this, feedback collected through questionnaires indicated that participants were willing to embrace the new technology, finding it comparable in ease of use to traditional devices, even among those with mild cognitive impairment.

Recommendations for Healthcare Providers

Professor Chaytor emphasized the importance of adequate training for older patients to facilitate their comfort with newer technologies. "Healthcare providers should anticipate that onboarding may take more time and effort for older individuals than younger populations, but the benefits are evident," she remarked.

Future Directions

As the findings suggest, the medical community should move towards more sophisticated hybrid closed loop systems, especially since predictive low glucose suspend systems have been phased out in the U.S. in favor of these newer technologies.

Conclusion

Overall, this research opens up exciting avenues for the advanced management of diabetes in older adults, marking a significant step forward in health technology and diabetes care.

For further details, refer to the study titled Automated Insulin Delivery in Older Adults with Type 1 Diabetes published in NEJM Evidence (2024).

References

Kudva, Y. C., et al. (2024). Automated Insulin Delivery in Older Adults with Type 1 Diabetes. NEJM Evidence. Retrieved from Science X News.