{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T21:48:12Z","timestamp":1789595292670,"version":"build-2803163510"},"reference-count":29,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K01 AG076971"],"award-info":[{"award-number":["K01 AG076971"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Cook Group","award":["Incorporated Advances in Medicine Award"],"award-info":[{"award-number":["Incorporated Advances in Medicine Award"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Diabetes Sci Technol"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Older adults with type 2 diabetes experience high risk of hypoglycemia, yet clinicians often lack actionable glucose data to guide individualized treatment decisions. This study examined how standardized continuous glucose monitoring (CGM) reports inform clinicians\u2019 decision-making using Endsley\u2019s situation awareness (SA) framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted semi-structured interviews. Thirty clinicians reviewed three simulated older adult type 2 diabetes cases before and after reviewing CGM reports. Data saturation was achieved, consistent with qualitative research standards. Using an SA informed framework, we analyzed the proportion of clinicians referencing specific data elements and describing changes in diagnostic reasoning and treatment decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>After CGM data review, clinicians frequently revised assessments and plans. Most clinicians (90%) incorporated time-in-range metrics, while 93% identified previously unrecognized hypoglycemia or nocturnal patterns. Continuous glucose monitoring data led 86% of clinicians to modify their original treatment plan, including deprescribing high-risk agents (eg, sulfonylureas), adjusting insulin timing or dosing, or initiating safer alternatives (eg, SGLT-2 inhibitors, GLP-1 receptor agonists). Clinicians also identified multiple barriers to treatment implementation, including cost, medication access, housing instability, and limited food security.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Continuous glucose monitoring data\u2014compared with A1C alone\u2014provided meaningful, actionable information that improved individualized treatment decisions for older adults with type 2 diabetes. Continuous glucose monitoring data enhanced clinicians\u2019 perception, comprehension, and projection across the SA continuum, fostering more confident diagnostic reasoning and safer treatment strategies. These findings inform the design of SA-based clinical decision-support tools to better integrate CGM data, address contextual barriers, and optimize management of older adults with type 2 diabetes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19322968261449829","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T09:10:30Z","timestamp":1778836230000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["How Continuous Glucose Monitoring Reports Inform Clinical Decision-Making for Older Adults With Type 2 Diabetes: Mapping Clinical Workflow to Situation Awareness"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9002-9234","authenticated-orcid":false,"given":"April","family":"Savoy","sequence":"first","affiliation":[{"name":"Edwardson School of Industrial Engineering, Purdue University, West Lafayette, IN, USA"},{"name":"Center for Health Information and Communication, United States Department of Veterans Affairs (VA), Veterans Health Administration, Health Systems Research, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA"},{"name":"Regenstrief Institute, Inc., Indianapolis, IN, USA"},{"name":"Division of Endocrinology &amp; Metabolism, Indiana University School of Medicine, Indianapolis, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Barboi","sequence":"additional","affiliation":[{"name":"Regenstrief Institute, Inc., Indianapolis, IN, USA"},{"name":"Division of Endocrinology &amp; Metabolism, Indiana University School of Medicine, Indianapolis, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Bibat","sequence":"additional","affiliation":[{"name":"Regenstrief Institute, Inc., Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Meanwell","sequence":"additional","affiliation":[{"name":"Department of Sociology, Indiana University, Bloomington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3827-7107","authenticated-orcid":false,"given":"Viral N.","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Endocrinology &amp; Metabolism, Indiana University School of Medicine, Indianapolis, USA"},{"name":"Center for Diabetes and Metabolic Diseases, Indiana University School of Medicine, Indianapolis, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Weiner","sequence":"additional","affiliation":[{"name":"Regenstrief Institute, Inc., Indianapolis, IN, USA"},{"name":"Center for the Study of Healthcare Innovation, Implementation and Policy, US Department of Veterans Affairs, Veterans Health Administration, Health Systems Research, VA Greater Los Angeles Healthcare System, CA, USA"},{"name":"David Geffen School of Medicine, University of California, Los Angeles, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-0114"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc24-1058"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.2337\/dci19-0069"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.2337\/dci23-0021"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.2337\/dca25-0006"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc24-1069"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-025-01720-z"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/19322968241234651"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.2337\/db25-5-OR"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-0116"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.2337\/cd24-0072"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.2337\/ds19-0029"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1518\/001872095779049543"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.2337\/db22-912-P"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc25-S013"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0232076"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/1525822X17749386"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.2337\/dci19-0028"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-18539-2"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)07683-3"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc25-S006"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40266-025-01236-y"},{"key":"e_1_3_3_24_2","volume-title":"Time in Range in the 2025 ADA Standards of Care","author":"Hall A.","year":"2025","unstructured":"Hall A. Time in Range in the 2025 ADA Standards of Care. Time in Range Coalition; 2025."},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.2337\/cd23-0092"},{"key":"e_1_3_3_26_2","article-title":"Standards of care in diabetes\u20142025","volume":"48","author":"American Diabetes Association","year":"2025","unstructured":"American Diabetes Association. Standards of care in diabetes\u20142025. Diabetes Care. 2025;48(suppl. 1):S1-S180.","journal-title":"Diabetes Care"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.15277\/bjd.2021.292"},{"key":"e_1_3_3_28_2","unstructured":"Espinoza J Klonoff D Vidmar A et al. Icode Report: CGM-EHR Integration Standards and Recommendations. Diabetes Technology Society; 2022. 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