SAT-528 - Characterizing Diabetes Technology Supply Use and Access Among Older Adults with Type 1 Diabetes

The prevalence of adults ≥ 65 years of age with type 1 diabetes (T1D) is increasing. Studies have demonstrated the benefits of using diabetes technology such as continuous glucose monitoring (CGM) in older adults, and professional guidelines recommend their use when appropriate. However, it is recognized that older adults are prescribed diabetes technology less frequently and there is a limited understanding of their experiences with these devices. The purpose of this study was to investigate the experience and challenges that older adults with T1D face in obtaining diabetes technology supplies. An online survey was administered through the T1D Exchange national registry in December 2023 with a focused analysis of responses from adults ≥ 65 years with T1D (n = 429) regarding the prior year. The cohort had a mean age of 70.9  16.2 years, a mean duration of diabetes of 42.1  18.9 years and mean A1c of 6.5  0.7%. Among those who utilized CGM and/or insulin pumps, respondents reported agreement that CGM and insulin pumps were useful in successful management of their diabetes with a mean score of 9.2 and 9.3 respectively on a scale of 1–10 where 10 represents “strongly agree”. Almost half (49%) of the cohort described challenges in receipt of diabetes supplies in the previous year. One or more interruption of any supply type during the year 2023 was reported in 32% of the cohort with 27% and 17% reporting interruption of supplies for CGM and insulin pump respectively. The most common reasons for interruptions were problems with the supply company processing refill requests (31%), delays in required prior authorization (26%), and obtaining updated prescriptions from provider (21%). The most common strategies for avoiding supply interruptions included calling the company to request additional supplies (47%), using supplies longer than indicated (40%), and asking providers to prescribe extra supplies (33%). Only 14% of the cohort agreed that they had difficulty affording the supplies that they needed. Previous studies have shown that older adults are able to learn and successfully use technology, and our survey has shown that they largely find technology beneficial and affordable. Understanding the experience of access interruptions and how to prevent them is an essential approach to achieving optimal diabetes management and outcomes in older adults with T1D.

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