361-OR: Hybrid Care Model Combining Telemedicine and Office Visits for Diabetes Management Is Effective in Older Adults with Type 1 Diabetes (T1D) Using Continuous Glucose Monitors (CGM)

Abstract

Objective: CGM improves glycemic control and mitigates hypoglycemia using office visits for older adults with T1D. During COVID-19 pandemic, a hybrid (in-office and telemedicine) care model was implemented. Data on impact of hybrid care model on glycemic control in older adults with T1D are limited. Methods: Demographic, clinical characteristics, and CGM metrics of older adults (age ≥65 yrs) with T1D were retrieved from electronic health records from 2 periods: pre-pandemic (April 1, 2019-March 1, 2020) and during pandemic (September 1, 2020 to August 31, 2021) (adjusted for length of follow-up). Results: 299 (47% male; mean age 72±4 years; 51% pump users) older adult CGM users were seen in both periods. Comparison of CGM metrics (Table) between time periods showed no changes in overall control (mean glucose 170±31 vs 168±33 mg/dL; p=0.75), glucose management indicator (GMI) (7.4 vs 7.3% p=0.65) or coefficient of variation (CV) (36% vs 35%; p=0.82). During hybrid model of care, time in-range (64±15 vs 72±15%; p<0.001) improved, while time <70 mg/dL did not increase. Conclusion: Glycemic control using a hybrid-care model was maintained compared with in-person visits in older adults with T1D using CGM without impacting risk of hypoglycemia. Further studies can clarify how to routinely use a hybrid-care model in older adults with T1D. Disclosure E.Toschi: Advisory Panel; Eli Lilly and Company. A.Adam: None. R.Hurlbert: None. N.Frimpong: None. C.Slyne: None. L.M.Laffel: Advisory Panel; Medtronic, Lilly Diabetes, Novo Nordisk, Vertex Pharmaceuticals Incorporated, Roche Diagnostics, Provention Bio, Inc., Consultant; Dexcom, Inc., Janssen Pharmaceuticals, Inc., Medscape. M.Munshi: Consultant; Sanofi. Funding Thomas J. Beatson, Jr. Foundation