Introduction and Objective: Hypoglycemia in older adults with type 2 diabetes (T2D) increases risk of falls, cognitive decline, hospitalization, and mortality. While Continuous Glucose Monitors (CGMs) can improve hypoglycemia identification, preventing repeat hypoglycemia requires behavioral and/or management changes. The Safer Aging with Diabetes Monitoring SAGE clinical trial (NCT06296485) is testing CGM with pharmacist-led group education sessions in insulin-using adults with T2D aged ≥ 75 years. Here we identify key themes that emerged during pharmacist-led group sessions. Methods: The SAGE intervention includes new CGM starts followed by two pharmacist-led virtual groups sessions, one month apart, to review and discuss participant-reported, CGM-identified hypoglycemia events. Detailed field notes from four trained study staff were thematically coded and analyzed using a grounded theory approach. Results: We analyzed 32 group sessions (July 2024-October 2025) with 61 study participants (age 79.8 +/- 3.4 years; 34 women, 27 men). Three key themes emerged: (1) Cognitive shifting (e.g., from reactive to proactive glycemic monitoring, from avoiding lows/highs to maintaining time-in-range); (2) Proactive prevention (e.g., combining CGM data with session learnings to modify daily activities, identify root causes, and recognize hypoglycemia unawareness/nocturnal lows); and (3) Increased emotional safety (e.g., participants reported greater confidence and security to prevent/treat future lows). A fourth theme from the follow-up sessions was (4) Greater self-management confidence (e.g., patient-initiated conversations with providers that often led to deprescribing). Conclusion: Individualized CGM data combined with expert problem-solving guidance was associated with more engaged, proactive self-management. Future work should examine whether CGM prescription paired with tailored, experiential group education for diverse older adults reduces long-term hypoglycemia-related complications. Disclosure E.M. Fernandez: None. S.C. Gonzalez: None. O. Jamal: None. M. Tran: None. M. Chen: None. A.J. Karter: Research Support; Current; Dexcom, Inc. L.K. Gilliam: None. R.W. Grant: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R01DK134446)
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