The Growing Role of Technology in the Care of Older Adults With Diabetes

Elbert S Huang¹, Alan Sinclair², Paul R Conlin^{3

4}, Tali Cukierman-Yaffe^{5

6

7}, Irl B Hirsch⁸, Megan Huisingh-Scheetz¹, Anna R Kahkoska⁹, Lori Laffel¹⁰, Alexandra K Lee¹¹, Sei Lee¹¹, Kasia Lipska¹², Graydon Meneilly¹³, Naushira Pandya¹⁴, Monica E Peek¹, Anne Peters¹⁵, Richard E Pratley¹⁶, Diana Sherifali¹⁷, Elena Toschi¹⁰, Guillermo Umpierrez¹⁸, Ruth S Weinstock¹⁹, Medha Munshi¹⁰

Affiliations

¹ University of Chicago, Chicago, IL.
² King's College, London, U.K.
³ Harvard Medical School, Boston, MA.
⁴ Veteran Affairs Boston Healthcare System, Boston, MA.
⁵ Division of Endocrinology, Diabetes, and Metabolism, Ramat Gan, Israel.
⁶ Sheba Medical Centre, Ramat Gan, Israel.
⁷ Epidemiology Department, Sackler Faculty of Medicine, Herczeg Institute on Aging, Tel Aviv University, Tel Aviv, Israel.
⁸ University of Washington, Seattle, WA.
⁹ University of North Carolina Chapel Hill, Chapel Hill, NC.
¹⁰ Joslin Diabetes Center, Boston, MA.
¹¹ University of California San Francisco, San Francisco, CA.
¹² Yale University, New Haven, CT.
¹³ University of British Columbia, Vancouver, British Columbia, Canada.
¹⁴ Department of Geriatrics, Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Ft. Lauderdale, FL.
¹⁵ University of Southern California, Los Angeles, CA.
¹⁶ AdventHealth Diabetes Institute, AdventHealth Translational Research Institute, AdventHealth, Orlando, FL.
¹⁷ McMaster University, Hamilton, Ontario, Canada.
¹⁸ Emory University, Atlanta, GA.
¹⁹ SUNY Upstate Medical University, Syracuse, NY.

PMID: 37471606
PMCID: PMC10369127
DOI: 10.2337/dci23-0021

Review

The Growing Role of Technology in the Care of Older Adults With Diabetes

Elbert S Huang et al. Diabetes Care. 2023.

. 2023 Aug 1;46(8):1455-1463.

doi: 10.2337/dci23-0021.

Authors

Affiliations

¹ University of Chicago, Chicago, IL.
² King's College, London, U.K.
³ Harvard Medical School, Boston, MA.
⁴ Veteran Affairs Boston Healthcare System, Boston, MA.
⁵ Division of Endocrinology, Diabetes, and Metabolism, Ramat Gan, Israel.
⁶ Sheba Medical Centre, Ramat Gan, Israel.
⁷ Epidemiology Department, Sackler Faculty of Medicine, Herczeg Institute on Aging, Tel Aviv University, Tel Aviv, Israel.
⁸ University of Washington, Seattle, WA.
⁹ University of North Carolina Chapel Hill, Chapel Hill, NC.
¹⁰ Joslin Diabetes Center, Boston, MA.
¹¹ University of California San Francisco, San Francisco, CA.
¹² Yale University, New Haven, CT.
¹³ University of British Columbia, Vancouver, British Columbia, Canada.
¹⁴ Department of Geriatrics, Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Ft. Lauderdale, FL.
¹⁵ University of Southern California, Los Angeles, CA.
¹⁶ AdventHealth Diabetes Institute, AdventHealth Translational Research Institute, AdventHealth, Orlando, FL.
¹⁷ McMaster University, Hamilton, Ontario, Canada.
¹⁸ Emory University, Atlanta, GA.
¹⁹ SUNY Upstate Medical University, Syracuse, NY.

PMID: 37471606
PMCID: PMC10369127
DOI: 10.2337/dci23-0021

Abstract

The integration of technologies such as continuous glucose monitors, insulin pumps, and smart pens into diabetes management has the potential to support the transformation of health care services that provide a higher quality of diabetes care, lower costs and administrative burdens, and greater empowerment for people with diabetes and their caregivers. Among people with diabetes, older adults are a distinct subpopulation in terms of their clinical heterogeneity, care priorities, and technology integration. The scientific evidence and clinical experience with these technologies among older adults are growing but are still modest. In this review, we describe the current knowledge regarding the impact of technology in older adults with diabetes, identify major barriers to the use of existing and emerging technologies, describe areas of care that could be optimized by technology, and identify areas for future research to fulfill the potential promise of evidence-based technology integrated into care for this important population.

PubMed Disclaimer

Conflict of interest statement

Funding and Duality of Interest. The International Geriatric Diabetes Society gratefully acknowledges the support of Abbott Diabetes Care, Dexcom, Medtronic, and Sanofi and the unrestricted educational grant provided by Novo Nordisk, Inc., for the International Geriatric Diabetes Technology Workshop. Discussion and debate that took place at the workshop led to the development of the content for this manuscript. E.S.H. reports support from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the National Institute on Aging (NIA), National Institutes of Health (NIH) (R01 AG063391, R01 DK127961, R01 AG060756, K24 AG069080, and P30 DK092949). M.H.S. is also supported by R01 DK127961. P.R.C. is supported by grants from the NIH (R01 DK114098 and UL1 TR002541) and the Department of Veterans Affairs, Health Services Research, and Development (I01 HX003527). A.R.K. is supported by the National Center for Advancing Translational Sciences, NIH, through grant KL2TR002490. A.R.K. also reports receiving research grants from the Diabetes Research Connection and the ADA as well as a prize from the National Academy of Medicine outside the submitted work. R.E.P. reports support from the NIH (U01 DK127392, R01 DK122603, U01 DK135131, and DP3DK113358). R.E.P. reports advisory board/consultant fees from Bayer AG, Corcept Therapeutics, Inc., Dexcom, Gasherbrum Bio, Inc., Hanmi Pharmaceutical Co., Hengrui (USA), Ltd., Merck, Novo Nordisk, Pfizer, Rivus Pharmaceuticals, Sanofi, Scohia Pharma, Inc., and Sun Pharmaceutical Industries. R.E.P. reports speaker bureau fees from Merck and Novo Nordisk. R.E.P. reports research support from Dompe, Hanmi Pharmaceuticals Co., Metavention, Novo Nordisk, and Poxel SA. E.T. reports use of Dexcom CGMs in a study sponsored by the Leona M. and Harry B. Helmsley Charitable Trust. T.C.-Y. reports serving on the speaker’s bureaus for Eli Lilly, Sanofi, MSD, Novo Nordisk, Medtronic, Geffen Medical, AstraZeneca, and Boehringer Ingelheim as well as receiving research support from Medtronic, Novo Nordisk, and MSD. R.S.W. participates or has recently participated in multicenter clinical trials, through her institution, sponsored by Insulet, Eli Lilly, Novo Nordisk, Medtronic, Diasome, and Boehringer Ingelheim. Tandem insulin pumps with Dexcom CGMs are being used in an NIDDK-sponsored study, and Dexcom CGMs are being/have been used in studies sponsored by the Leona M. and Harry B. Helmsley Charitable Trust and NIDDK. No other potential conflicts of interest relevant to this article were reported.

Figures

**Figure 1**
Potential roles of technology in the care of older adults with diabetes across settings. NA, not applicable; Tech, technology.

See this image and copyright information in PMC

References

1. Laiteerapong N, Huang ES. Diabetes in older adults, 3rd edition. In Diabetes in America. Cowie CC, Casagrande SS, Menke Andy, et al., Eds. Bethesda, MD, National Institute of Diabetes and Digestive and Kidney Diseases, 2018. - PubMed
1. Centers for Disease Control and Prevention . National Diabetes Statistics Report website. Accessed 27 April 2023. Available from https://www.cdc.gov/diabetes/data/statistics-report/index.html
1. Munshi MN, Florez H, Huang ES, et al. . Management of diabetes in long-term care and skilled nursing facilities: a position statement of the American Diabetes Association. Diabetes Care 2016;39:308–318 - PMC - PubMed
1. American Diabetes Association . Economic costs of diabetes in the U.S. in 2017. Diabetes Care 2018;41:917–928 - PMC - PubMed
1. Huang ES, Laiteerapong N, Liu JY, John PM, Moffet HH, Karter AJ. Rates of complications and mortality in older patients with diabetes mellitus: the diabetes and aging study. JAMA Intern Med 2014;174:251–258 - PMC - PubMed

Publication types

Actions
Actions
Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

The Growing Role of Technology in the Care of Older Adults With Diabetes

Affiliations

The Growing Role of Technology in the Care of Older Adults With Diabetes

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources