527-P: Mapping the Educational Infrastructure Required for Successful Remote CGM Implementation in Older Adults

Introduction and Objective: The REST (Readiness, Education and Sustainability for CGM Technology adoption) study utilized remote education to facilitate continuous glucose monitoring (CGM) adoption in older adults on complex insulin regimens, while building a framework for sustained use. Medicare allows limited diabetes education hours, and little is known about the educational support requirements and implementation challenges in this age group. We interviewed certified diabetes care and education specialists (CDCES) to assess the challenges and facilitators of remote CGM education in older adults. Methods: Semi-structured interviews were conducted with 6 CDCES. Interviews were recorded, transcribed verbatim, and analyzed using MaxQDA by a multidisciplinary team. Results: Four main themes were explored: (1) clinical workflow (100% reported needing to significantly adapt their teaching approaches, requiring 2-3X more time than standard diabetes education visits); (2) age-related adaptations: 3 approaches were developed based on participant cognitive/physical/technological competencies and support system: standard remote delivery, enhanced remote support including caregivers, hybrid remote/in-person visits. Teaching was modified using simplified instructions, more repetition, and multi-modal formats (written, visual, hands-on); (3) resource requirements (83% extended sessions and more comprehension checks); (4) implementation barriers (video platform difficulties (83%), CGM device setup issues (67%), and time requirements (100%)). Conclusion: Successful CGM implementation in older adults requires substantial adaptation of traditional education approaches using simplified, multi-modal teaching methods. These adaptations demand significantly more educator time than currently supported by Medicare. Our findings suggest a critical need to realign reimbursement with the education requirements of older adults adopting diabetes technology. Disclosure A. Adam: None. H. Brabant: None. C. Slyne: None. M. Savory: None. N. Krakoff: None. J.D. Bulger: None. S. Kasetti: None. M. Munshi: Advisory Panel; Abbott, Medtronic. Research Support; Dexcom, Inc. Advisory Panel; Sanofi. R.S. Weinstock: Research Support; Amgen Inc, Eli Lilly and Company, Tandem Diabetes Care, Inc, Diasome Pharmaceuticals, Insulet Corporation, MannKind Corporation, Dexcom, Inc. E. Toschi: Consultant; Vertex Pharmaceuticals Incorporated, Sequel Med Tech. Research Support; Dexcom, Inc. Funding This work was supported by a grant from The Leona M. and Harry B. Helmsley Charitable Trust