Introduction and Objective: Older adults benefit from continuous glucose monitoring (CGM) use, but CGM initiation and sustained use often require intensive educator support, and time requirements are poorly characterized. We quantified educator time and support needs during the REST study. Methods: REST is a prospective 12-month study conducted in older adults (≥65 years) with insulin-treated diabetes, either CGM-naïve or CGM users not meeting glycemic targets (TIR 40% and/or hypoglycemia 4%). The intervention combined remote CGM education with geriatric principles, including individualized glycemic goals and insulin regimen simplification based on CGM patterns. Educator minutes were logged for 14 scheduled (expected to total 7.5 hr/12 month) and unscheduled visits over 12 months. Scheduled time was the sum of mean minutes across scheduled visits; unscheduled time was the time and proportion of participants with ≥1/≥2/≥3 visits. Educator interviews (n=6) used grounded theory. Results: Among REST participants (N=108), actual total educator time required was 12.5 hours/participant over 12 months, comprising total scheduled time of 10.3 hours, plus an additional 2.2 hours of unscheduled time. Initial CGM education averaged 83±35 minutes (median 78 minutes); mean duration for 13 follow-up visits ranged 34-53 minutes. Eighty-two percent of participants required ≥1 unscheduled visit, 64% required ≥2 unscheduled visits, and 56% required ≥3 unscheduled visits. Qualitative findings included educators describing frequent ad hoc reinforcement (troubleshooting, alarm adjustments, interpretation support, and caregiver coordination). Conclusion: Remote CGM education for older adults required substantial educator time, exceeding the ample allotted time planned per protocol, and requiring at least one extra unscheduled visit due to the need for frequent reinforcement in 80% of participants. These findings highlight that CGM education for older adults is time-intensive and requires ongoing flexibility and frequent educator engagement. Disclosure A. Adam: None. M. Savory: None. C. Slyne: None. H. Brabant: None. B. Matthews: None. A. Bradshaw: None. J. Bulger: None. N. Krakoff: None. M. Munshi: Advisory Panel; Current; Abbott Diabetes. Research Support; Ended; Dexcom, Inc. R. Weinstock: Research Support; Current; Amgen Inc., Eli Lilly and Company, JDRF, Diasome, DEKA Research and Development, Tandem Diabetes Care, Inc. Research Support; Ended; Kowa Research Institute, Inc. Research Support; Current; National Institutes of Health. Research Support; Ended; Insulet Corporation. Research Support; Current; T1D Exchange. E. Toschi: Consultant; Current; Vertex Pharmaceuticals Incorporated. Advisory Panel; Current; Vertex Pharmaceuticals Incorporated. Funding Support provided by The Leona M. and Harry B. Helmsley Charitable Trust
Adam et al. (Mon,) studied this question.