Please choose one global burden of disease and one population (adult, pediatric, or geriatric). Once the population is chosen, find one evidence-based technology to help support the improvement of outcomes in the global burden of disease chosen.
Improving Outcomes in Type 2 Diabetes Among Geriatric Populations Through Continuous Glucose Monitoring (CGM) Technology
Introduction
The global burden of disease (GBD) continues to challenge public health systems worldwide, with non-communicable diseases (NCDs) such as type 2 diabetes mellitus (T2DM) contributing significantly to morbidity, mortality, and healthcare costs. According to the World Health Organization (WHO), over 422 million people globally are living with diabetes, with the majority affected by T2DM (WHO, 2023). Among the most vulnerable to its effects are geriatric populations, who face age-related physiological changes and comorbidities that complicate disease management. In this essay, T2DM is selected as the global burden of disease, the geriatric population as the target group, and continuous glucose monitoring (CGM) as an evidence-based technology shown to improve health outcomes.
The Burden of Type 2 Diabetes in the Geriatric Population
The prevalence of T2DM increases significantly with age, impacting nearly 27% of adults aged 65 and older in the United States alone (American Diabetes Association [ADA], 2022). Older adults with T2DM are at higher risk of cardiovascular disease, renal failure, neuropathy, vision loss, and lower-limb amputations. Additionally, the geriatric population faces unique challenges such as cognitive decline, polypharmacy, reduced physical mobility, and limited access to technology, which can hinder effective disease self-management.
Managing blood glucose levels in older adults is also complicated by the increased risk of hypoglycemia and the presence of other chronic conditions. Traditional methods of monitoring, such as fingerstick testing, are often burdensome and may not provide sufficient insight into daily glucose fluctuations. Thus, new technological interventions are necessary to support individualized, safe, and effective diabetes care for this demographic.
Continuous Glucose Monitoring (CGM): An Evidence-Based Technology
Continuous glucose monitoring (CGM) is a minimally invasive technology that tracks glucose levels in real time throughout the day and night via a sensor placed under the skin. CGM devices alert users of hypo- or hyperglycemia, display trends in glucose variation, and store data that can be shared with healthcare providers to guide treatment decisions. CGM systems have demonstrated significant benefits in improving glycemic control, reducing HbA1c levels, and decreasing the frequency and severity of hypoglycemia events (Beck et al., 2017).
In geriatric populations, CGM has been associated with improved self-efficacy, quality of life, and reduced emergency room visits due to diabetes-related complications. A study by Pratley et al. (2020) revealed that older adults using CGM experienced fewer hypoglycemic episodes and improved glucose stability without the need for more aggressive pharmacologic interventions. Additionally, caregivers can monitor glucose remotely, adding a safety layer for patients who may be cognitively impaired or living alone.
Implementation and Considerations
Despite its benefits, barriers to the widespread adoption of CGM in geriatric care include cost, insurance coverage, device usability, and technological literacy. Addressing these barriers involves policy support for reimbursement, patient and caregiver education programs, and integrating CGM data into routine geriatric care. Training geriatric care providers to interpret CGM data and tailor interventions accordingly is also essential for maximizing the technology’s potential.
Conclusion
Type 2 diabetes mellitus is a significant global burden, particularly for the growing geriatric population. Continuous glucose monitoring offers a practical, evidence-based approach to improve diabetes management and outcomes in older adults. By providing real-time feedback, reducing complications, and enhancing quality of life, CGM represents a pivotal advancement in chronic disease management. Integrating CGM into geriatric diabetes care requires multidisciplinary collaboration, patient-centered strategies, and systemic support to overcome implementation barriers and ensure equitable access.
References
American Diabetes Association. (2022). Statistics about diabetes. https://www.diabetes.org/about-us/statistics
Beck, R. W., Riddlesworth, T., Ruedy, K., Ahmann, A., Bergenstal, R., Haller, S., … & Price, D. (2017). Effect of continuous glucose monitoring on glycemic control in adults with type 1 diabetes using insulin injections: The DIAMOND randomized clinical trial. JAMA, 317(4), 371–378. https://doi.org/10.1001/jama.2016.19975
Pratley, R. E., Kanapka, L. G., Rickels, M. R., Ahmann, A., Aleppo, G., Beck, R., … & Bergenstal, R. M. (2020). Effect of continuous glucose monitoring on hypoglycemia in older adults with type 1 diabetes: A randomized clinical trial. JAMA, 323(24), 2397–2406. https://doi.org/10.1001/jama.2020.6928
World Health Organization. (2023). Diabetes. https://www.who.int/news-room/fact-sheets/detail/diabetes
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