Impact of Simplification Strategies on Postmeal Glucose Excursions in Older Adults with Type 1 Diabetes and Hypoglycemia

Continuous glucose monitoring with simplification strategies reduces hypoglycemia in older adults with type 1 diabetes (T1D), however the impact on postmeal glycemia is not known. A post-hoc analysis of older adults with T1D randomized to intervention with mealtime simplification strategies, or control, assessed weekly postmeal hypoglycemia and hyperglycemia. At baseline, 88 older adults with T1D (71 ± 5 years) in intervention (n = 47) and control (n = 41) had similar number of episodes of postmeal hypo- and hyperglycemia. The mean decrease from baseline to 6 months in episodes of postmeal hypoglycemia was: after breakfast (−0.77 vs. −0.32; P = 0.02), lunch (−0.80 vs. −0.32; P = 0.05), and dinner (−0.73 vs. −0.22; P = 0.04); and the mean change in episodes of postmeal hyperglycemia was: after breakfast (−2.05 vs. −1; P = 0.04), lunch (−1.23 vs. −0.87; P = 0.09), and dinner (−1.45 vs. −1.66; P = 0.33), respectively in intervention and control. Simplification strategies in older adults with T1D resulted in fewer episodes of postmeal hypoglycemia without worsening episodes of postmeal hyperglycemia.