Using advanced diabetes technologies in patients with dementia in assisted living facilities: Case studies

Abstract

Introduction: Older adults with dementia and diabetes are at increased risk of complications, hospitalizations, and adverse events. This vulnerable patient population may have high glucose variability and an increased risk of low and high glucose numbers. Diabetes technology exists, including insulin pumps and continuous glucose monitors, which may be effective in optimally managing blood sugar in this patient population. Case Presentation: We detail two older adults with diabetes living in assisted living facilities. The first case study describes the successful use of an insulin pump in an older adult with type 1 diabetes and dementia. The second case study demonstrates successful use of continuous glucose monitoring in an older adult with type 1 diabetes and dementia. Discussion: These case studies provide initial evidence that insulin pump and continuous glucose monitoring technologies can successfully be used by older adults with dementia and used to assist in diabetes management in an assisted living facility. Clinical Implications: Use of wearable diabetes technology improves the care of patients with diabetes. These case studies demonstrate initial evidence supporting improvement in the care of older adults with diabetes by the use of technology.

Keywords:

• caregivers
• technology
• assisted living facility < long-term care
• dementia < neurological disorders

Public Interest Statement

Older adults with dementia and diabetes are at increased risk of complications, hospitalizations, and adverse events. This vulnerable patient population may have high glucose variability and an increased risk of low and high glucose numbers. Diabetes technology exists, including insulin pumps and continuous glucose monitors, which may be effective in optimally managing blood glucose in this patient population. Insulin pumps deliver rapid acting insulin 24 h/day and can be customized to fit patient’s need. Continuous glucose monitors measure glucose every 5 min and present glucose readings in real-time. This case study details initial evidence of the successful use of insulin pump and CGM technologies in two older adults with dementia. Older adults with diabetes are living longer and will expect to take their insulin pumps and CGM devices with them to assisted care facilities. More research is needed in this population.

Competing Interests

The authors declare no competing interest.

Additional information

Notes on contributors

Nancy A. Allen

Nancy A. Allen, PhD, ANP-BC is an assistant professor and an Adult Nurse Practitioner at the Cognitive Disorders Clinic. She completed a Mini-Fellowship in Cognitive Disorders after 17 years of practice and research in diabetes. She researches the use of technology in older adults to effect behavior changes.

Michelle L. Litchman

Michelle L. Litchman PhD, FNP, FANP is an assistant professor and Family Nurse Practitioner at the Utah Diabetes and Endocrinology Center. She developed and directed a diabetes specialty house call program servicing older adults for several years. Her program of research is focused on how individuals manage their diabetes in the context of technology and peer health support.

Alisyn L. May

Alisyn L. May PharmD, BCACP, CDE is an assistant professor and a Clinical Pharmacist at the ARUP Family Health Clinic. Her program of research is focused on therapeutics in geriatric care, shared decision making, and novel approaches to engage patients in their healthcare.