by Prateek Chopra | June 11, 2026 | Diabetes Conferences | ADA 2026 | 0 comments
Modeling Approach:
- This study evaluated the 10-year clinical, economic, and quality-of-life impact of the REST intervention, a geriatric-focused continuous glucose monitoring (CGM) education program for older adults with insulin treated diabetes.
- Participants were adults aged ≥65 years with type 1 diabetes (T1D) or type 2 diabetes (T2D) who were either CGM-naïve or not achieving glycemic targets.
Intervention:
- The REST program combined remote CGM education with geriatric care principles.
- Individualized glycemic targets and insulin regimen simplification were guided by CGM data.
- Outcomes from REST were incorporated into the CDC/RTI diabetes microsimulation model using an adjusted mean HbA1c reduction of 0.49% over six months.
Projected Clinical Outcomes:
- Simulations projected outcomes over 10 years for both T1D and T2D populations.
Benefits in Type 1 Diabetes:
- Major adverse cardiovascular events reduced by 2.54%.
- End-stage renal disease reduced by 6.53%.
- Proliferative diabetic retinopathy reduced by 17.4%.
- Amputation reduced by 12.8%.
- Mortality reduced by 2.85%.
Benefits in Type 2 Diabetes:
- Stroke reduced by 2.52%.
- Myocardial infarction reduced by 2.76%.
- Revascularization reduced by 2.83%.
- Dialysis reduced by 5.01%.
- Mortality reduced by 2.17%.
Quality of Life and Economic Outcomes:
- Quality-adjusted life years (QALYs) increased by 0.075 in T1D.
- QALYs increased by 0.040 in T2D.
- Healthcare costs increased only modestly despite improvements in outcomes.
- Average modeled follow-up was approximately 7.5 years.
Clinical Implications:
- Geriatric-focused CGM education may reduce both diabetes-related and cardiovascular complications.
- The intervention oers a scalable approach to improving diabetes management in older adults receiving insulin therapy.
Long-term projections based on the REST intervention demonstrated meaningful reductions in diabetes- and cardiovascular-related complications, lower mortality, and improved quality-adjusted
survival in older adults with insulin-treated diabetes. These findings support the value of geriatric tailored CGM education as a cost-eective strategy for improving outcomes in this high-risk population.