147-OR: Use of Closed-Loop Insulin Therapy in Older Adults with Type 1 Diabetes: Real-World Experience

Background: Closed-loop control insulin delivery systems (CLC) have been available to adults with type 1 diabetes (T1D) for many years. However, for older adults with T1D, Tandem Control IQ is the first CLC available through Medicare. We evaluated the use of CLC in older adults with T1D in a real-world scenario. Methods: We retrospectively analyzed electronic health record (EHR) data for older adults (>65) with T1D started on CLC in a single tertiary center between January and December 2020. Continuous glucose monitoring (CGM) data from the 2 weeks prior (baseline) and 2 weeks post CLC system (post-CLC) initiation were analyzed. We evaluated glycemic measures, including coefficient of variation (CV) for glucose variability and glucose management indicator (GMI) for overall glycemic control. Demographic, clinical and diabetes technology data were gathered from EHR. Results: We present interim data from 25 older adults (Mean age 69±4 yrs, duration of diabetes 43±13 yrs) who started using CLC over the 12 month period. Overall, 23/25 were prior pump users, and 23/25 were prior CGM users. Only 2/25 discontinued CLC use. Comparison of CGM metrics measured at baseline vs. post-CLC showed an increase in Time in Range (TIR) from 63±13% to 77±9% (p 180 mg/dL from 30±12% to 18±9% (p=0.004). While there was a trend in decrease of time Conclusion: In a small cohort of older adults with T1D using CLC in a real-world scenario, the majority of the cohort was able to use the system successfully, resulting in a higher TIR and improved glycemic variability, as seen by a decrease in CV over a 3 month period. Thus, CLC has the potential to improve glycemic outcomes in this elderly population. Disclosure E. Toschi: Consultant; Self; Medtronic. C. Slyne: None. A. Atakov-castillo: None. M. Munshi: Consultant; Self; Sanofi. Funding National Institutes of Health (1DP3DK112214-01)