380-P: Hypoglycemia among Nursing Home Residents with Diabetes Detected by Continuous Glucose Monitoring (CGM)

Few data exist on the frequency of hypoglycemia among nursing home residents with diabetes. We recruited patients 65 years or older, with type 1 or type 2 diabetes, on standing insulin or sulfonylureas, who were long-term residents at 10 Connecticut nursing homes. After informed consent, Freestyle Libre CGM devices were placed for 14 days of blinded monitoring. After omitting the first 24 hours of data, we calculated the percentage (%) of 24-hr periods with at least 2 consecutive blood glucose (BG) levels Among 35 patients who completed the study, 33 had at least 7 days of CGM data. Median age was 80 [IQR 71-86], 46% men, 36% nonwhite, HbA1c 7.3 [IQR 6.5-8.5], ADL disability score 26 [IQR 22-27, max possible value=35], 52% had dementia, 39% chronic kidney disease, and 97% were on insulin. More than 1 in 3 (38% (IQR 15-62%)) of the patient-24 hr CGM periods contained at least 2 consecutive BGs Hypoglycemia detected by flash CGM is common but otherwise under-recognized among older, long-term residents of nursing homes treated with insulin or sulfonylureas. Disclosure K.J. Lipska: None. M.M. Doyle: None. E. Cengiz: Advisory Panel; Self; ADOCIA, Arecor, Lexicon Pharmaceuticals, Inc., MannKind Corporation, Novo Nordisk Inc. Speaker’s Bureau; Self; Novo Nordisk Inc. B. Drozdowicz: None. T.M. Gill: None. T.E. Murphy: None. S.E. Inzucchi: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Lexicon Pharmaceuticals, Inc., Novo Nordisk A/S, Sanofi. Consultant; Self; Abbott, Merck & Co., Inc., vTv Therapeutics. Funding National Institutes of Health (P30DK045735)