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Continuous glucose monitoring in older people with diabetes receiving home care - A feasibility study
Marit Graue
Hogskulen pa Vestlandet Avdeling for helse- og sosialfag
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3149-6227
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This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Pilot and Feasibility Studies.
Background Hypoglycemic incidents in older people can cause severe health problems, enhance general age-related disabilities and cause frailty. Little is known about incidences of hypoglycemia in older home-dwelling people with diabetes. Thus, the aim of this study was to examine the feasibility of capturing hypoglycemia and issues associated with increased risk of hypoglycemia by use of continuous glucose monitoring (CGM) and standardized questionnaires among older home dwelling individuals with diabetes type 2 receiving home care.
Methods CGM with the Ipro2 blinded monitoring system were performed for five days in six home-dwelling individuals ≥ 75 years diagnosed with diabetes and receiving home care. Demographic (age, gender, living arrangements) and clinical data (diabetes diagnoses and duration, diabetes medication, documented treatment goal, available glycosylated hemoglobin (HbA1c),) were collected from electronic patient records in home care services. Feasibility (ease of use, quality of data, time spent) of standardized questionnaires to identify the risk of hypoglycemia (the McKellar Risk Assessment Tool), risk of malnutrition (the Mini Nutritional Assessment (MNA)), functional status (the Individual-based Statistics for Nursing and Care Services (IPLOS)) and cognitive status (the Mini Mental Status Exam (MMSE)) was also assessed. Questionnaire data was collected by a study nurse in the individuals’ home.
Results The practical use of CGM was satisfactory, with no major remarks about discomfort or technical errors, except for one participant with skin reaction (redness). Collecting data with the McKellar Risk Assessment Tool, MNA and IPLOS worked well according to quality of data, time spent and ease of use. The MMSE survey required extensive training of personnel to be conducted.
Conclusion The feasibility study informs an upcoming study on the incidence and risk factors of hypoglycemia in home dwelling older individuals. We will ascertain that personnel who will use the MMSE questionnaire to collect cognitive status and skills are familiar with the tool and adequately educated and trained before study start. The use of blinded CGM in this population was well tolerated and can be used ‘as is’ for future studies.
Keywords
Diabetes, hypoglycemia, older people, HbA1c, home care
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CURRENT STATUS: Published
Version 4
Posted 18 Dec, 2020
Published
On 06 Jan, 2021
No community comments so far
Editorial decision: Accept
On 13 Dec, 2020
Editor assigned
On 05 Dec, 2020
Submission checks complete
On 05 Dec, 2020
Editor invited
On 05 Dec, 2020
No comments provided
Editorial decision: Minor revision
On 22 Nov, 2020
Review #1 received
Received 17 Nov, 2020
Editor assigned
On 15 Nov, 2020
Reviewers invited
Invitations sent on 15 Nov, 2020
Reviewer #1 agreed
On 15 Nov, 2020
Submission checks complete
On 15 Nov, 2020
Editor invited
On 15 Nov, 2020
No comments provided
Editorial decision: Minor revision
On 22 Oct, 2020
Review #2 received
Received 21 Oct, 2020
Reviewer #2 agreed
On 21 Sep, 2020
Reviewer #1 agreed
On 16 Sep, 2020
Review #1 received
Received 16 Sep, 2020
Editor assigned
On 14 Sep, 2020
Reviewers invited
Invitations sent on 14 Sep, 2020
Submission checks complete
On 13 Sep, 2020
Editor invited
On 13 Sep, 2020
No comments provided
Review #2 received
Received 13 Aug, 2020
Editorial decision: Major revision
On 13 Aug, 2020
Review #1 received
Received 06 Aug, 2020
Reviewer #2 agreed
On 14 Jul, 2020
Reviewers invited
Invitations sent on 08 Jul, 2020
Reviewer #1 agreed
On 08 Jul, 2020
First submitted
On 01 Jul, 2020
Editor assigned
On 01 Jul, 2020
Submission checks complete
On 30 Jun, 2020
Editor invited
On 30 Jun, 2020
Metrics
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PDF Downloads: ...
HTML Views: ...
Subject Areas
General Microbiology
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This preprint is under consideration at Pilot and Feasibility Studies. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Continuous glucose monitoring in older people with diabetes receiving home care - A feasibility study
Marit Graue
Hogskulen pa Vestlandet Avdeling for helse- og sosialfag
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3149-6227
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 4
Posted 18 Dec, 2020
Published
On 06 Jan, 2021
No community comments so far
Editorial decision: Accept
On 13 Dec, 2020
Editor assigned
On 05 Dec, 2020
Submission checks complete
On 05 Dec, 2020
Editor invited
On 05 Dec, 2020
No comments provided
Editorial decision: Minor revision
On 22 Nov, 2020
Review #1 received
Received 17 Nov, 2020
Editor assigned
On 15 Nov, 2020
Reviewers invited
Invitations sent on 15 Nov, 2020
Reviewer #1 agreed
On 15 Nov, 2020
Submission checks complete
On 15 Nov, 2020
Editor invited
On 15 Nov, 2020
No comments provided
Editorial decision: Minor revision
On 22 Oct, 2020
Review #2 received
Received 21 Oct, 2020
Reviewer #2 agreed
On 21 Sep, 2020
Reviewer #1 agreed
On 16 Sep, 2020
Review #1 received
Received 16 Sep, 2020
Editor assigned
On 14 Sep, 2020
Reviewers invited
Invitations sent on 14 Sep, 2020
Submission checks complete
On 13 Sep, 2020
Editor invited
On 13 Sep, 2020
No comments provided
Review #2 received
Received 13 Aug, 2020
Editorial decision: Major revision
On 13 Aug, 2020
Review #1 received
Received 06 Aug, 2020
Reviewer #2 agreed
On 14 Jul, 2020
Reviewers invited
Invitations sent on 08 Jul, 2020
Reviewer #1 agreed
On 08 Jul, 2020
First submitted
On 01 Jul, 2020
Editor assigned
On 01 Jul, 2020
Submission checks complete
On 30 Jun, 2020
Editor invited
On 30 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
General Microbiology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Pilot and Feasibility Studies.
Background Hypoglycemic incidents in older people can cause severe health problems, enhance general age-related disabilities and cause frailty. Little is known about incidences of hypoglycemia in older home-dwelling people with diabetes. Thus, the aim of this study was to examine the feasibility of capturing hypoglycemia and issues associated with increased risk of hypoglycemia by use of continuous glucose monitoring (CGM) and standardized questionnaires among older home dwelling individuals with diabetes type 2 receiving home care.
Methods CGM with the Ipro2 blinded monitoring system were performed for five days in six home-dwelling individuals ≥ 75 years diagnosed with diabetes and receiving home care. Demographic (age, gender, living arrangements) and clinical data (diabetes diagnoses and duration, diabetes medication, documented treatment goal, available glycosylated hemoglobin (HbA1c),) were collected from electronic patient records in home care services. Feasibility (ease of use, quality of data, time spent) of standardized questionnaires to identify the risk of hypoglycemia (the McKellar Risk Assessment Tool), risk of malnutrition (the Mini Nutritional Assessment (MNA)), functional status (the Individual-based Statistics for Nursing and Care Services (IPLOS)) and cognitive status (the Mini Mental Status Exam (MMSE)) was also assessed. Questionnaire data was collected by a study nurse in the individuals’ home.
Results The practical use of CGM was satisfactory, with no major remarks about discomfort or technical errors, except for one participant with skin reaction (redness). Collecting data with the McKellar Risk Assessment Tool, MNA and IPLOS worked well according to quality of data, time spent and ease of use. The MMSE survey required extensive training of personnel to be conducted.
Conclusion The feasibility study informs an upcoming study on the incidence and risk factors of hypoglycemia in home dwelling older individuals. We will ascertain that personnel who will use the MMSE questionnaire to collect cognitive status and skills are familiar with the tool and adequately educated and trained before study start. The use of blinded CGM in this population was well tolerated and can be used ‘as is’ for future studies.
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