{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T09:21:56Z","timestamp":1792142516293,"version":"4.4.0"},"reference-count":40,"publisher":"American Diabetes Association","issue":"8","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To assess time trends of and examine which sociodemographic and clinical characteristics are associated with continuous glucose monitoring (CGM) initiation in insulin-treated older adults with type 2 diabetes (T2D).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>Using data from Medicare Fee-for-Service (2013\u20132020) and Optum\u2019s deidentified Clinformatics Data Mart Database (Clinformatics) (2013\u20132022), we identified patients aged \u226565 years with T2D receiving insulin therapy who initiated CGM annually. Initiation of a CGM device was defined based on Current Procedural Terminology codes and National Drug Codes. Then, we 1:4 matched new users of CGM to patients unexposed to CGM, using risk set sampling. Index date was the date of CGM initiation or, for control participants, the closest physician visit within \u00b17 days. We used logistic regression to assess demographic and clinical characteristics associated with CGM initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The annual CGM initiation rate rose from 107 to 5,249\/100,000 in Medicare (2013\u20132020) and from 796 to 9,195\/100,000 in Clinformatics (2013\u20132022). Compared with White patients, Hispanic (odds ratio, 96% CI: 0.44, 0.42\u20130.48 in Medicare and 0.81, 0.78\u20130.85 in Clinformatics) and Black (0.71, 0.69\u20130.73 in Medicare and 0.89, 0.85\u20130.92 in Clinformatics) individuals were less likely to receive CGM. Older age and residing in low socioeconomic status areas were associated with lower CGM uptake, while history of hypoglycemia and lower frailty scores increased CGM initiation likelihood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>CGM initiation has increased over time but remains &amp;lt;10% among insulin-treated older adults with T2D. Substantial racial, ethnic, and socioeconomic disparities were observed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dca25-0006","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T12:47:02Z","timestamp":1748609222000},"page":"1377-1385","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":27,"title":["Overall Uptake and Racial, Ethnic, and Socioeconomic Disparities in the Use of Continuous Glucose Monitoring Devices Among Insulin-Treated Older Adults With Type 2 Diabetes"],"prefix":"10.2337","volume":"48","author":[{"given":"Wajd","family":"Alkabbani","sequence":"first","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School 1 , Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara J.","family":"Cromer","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School 1 , Boston, MA"},{"name":"Diabetes Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School 2 , Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dae Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School 3 , Boston, MA"},{"name":"Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center 4 , Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie M.","family":"Paik","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School 1 , Boston, MA"},{"name":"New England Geriatric Research Education and Clinical Center, Veterans Affairs Boston Healthcare System 5 , Boston, MA"},{"name":"Division of Renal (Kidney) Medicine, Department of Medicine, Brigham and Women\u2019s Hospital 6 , Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsiaryna","family":"Bykov","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School 1 , Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Medha","family":"Munshi","sequence":"additional","affiliation":[{"name":"Joslin Diabetes Center, Harvard Medical School 7 , Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah J.","family":"Wexler","sequence":"additional","affiliation":[{"name":"Diabetes Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School 2 , Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8809-9898","authenticated-orcid":false,"given":"Elisabetta","family":"Patorno","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School 1 , Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"2026061714321590900_B1","doi-asserted-by":"crossref","first-page":"60","DOI":"10.2337\/cd16-0008","article-title":"Continuous glucose monitoring: a perspective on its past, present, and future applications for diabetes management","volume":"35","author":"Mariani","year":"2017","journal-title":"Clin Diabetes"},{"key":"2026061714321590900_B2","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.dsx.2017.09.005","article-title":"A history of continuous glucose monitors (CGMs) in self-monitoring of diabetes mellitus","volume":"12","author":"Olczuk","year":"2018","journal-title":"Diabetes Metab Syndr"},{"key":"2026061714321590900_B3","doi-asserted-by":"crossref","first-page":"183","DOI":"10.2337\/ds18-0093","article-title":"Personal versus professional continuous glucose monitoring: when to use which on whom","volume":"32","author":"Longo","year":"2019","journal-title":"Diabetes Spectr"},{"key":"2026061714321590900_B4","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1038\/s41574-024-00973-1","article-title":"Continuous glucose monitoring for the routine care of type 2 diabetes mellitus","volume":"20","author":"Ajjan","year":"2024","journal-title":"Nat Rev Endocrinol"},{"key":"2026061714321590900_B5","doi-asserted-by":"crossref","first-page":"2262","DOI":"10.1001\/jama.2021.7444","article-title":"Effect of continuous glucose monitoring on glycemic control in patients with type 2 diabetes treated with basal insulin: a randomized clinical trial","volume":"325","author":"Martens","year":"2021","journal-title":"JAMA"},{"key":"2026061714321590900_B6","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1111\/dom.14949","article-title":"IMpact of flash glucose Monitoring in pEople with type 2 Diabetes Inadequately controlled with non-insulin Antihyperglycaemic ThErapy (IMMEDIATE): a randomized controlled trial","volume":"25","author":"Aronson","year":"2023","journal-title":"Diabetes Obes Metab"},{"key":"2026061714321590900_B7","doi-asserted-by":"crossref","first-page":"32","DOI":"10.2337\/dc11-1438","article-title":"Short- and long-term effects of real-time continuous glucose monitoring in patients with type 2 diabetes","volume":"35","author":"Vigersky","year":"2012","journal-title":"Diabetes Care"},{"key":"2026061714321590900_B8","doi-asserted-by":"crossref","first-page":"2273","DOI":"10.1001\/jama.2021.6530","article-title":"Association of real-time continuous glucose monitoring with glycemic 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with type 1 and type 2 diabetes using multiple daily injections of insulin: results from the DIAMOND trial","volume":"11","author":"Ruedy","year":"2017","journal-title":"J Diabetes Sci Technol"},{"key":"2026061714321590900_B12","doi-asserted-by":"crossref","first-page":"S111","DOI":"10.2337\/dc24-S006","article-title":"6. Glycemic goals and hypoglycemia: Standards of Care in Diabetes\u20142024","volume":"47","author":"American Diabetes Association Professional Practice Committee.","year":"2024","journal-title":"Diabetes Care."},{"key":"2026061714321590900_B13","doi-asserted-by":"crossref","first-page":"S126","DOI":"10.2337\/dc24-S007","article-title":"7. Diabetes technology: Standards of Care in Diabetes\u20142024","volume":"47","author":"American Diabetes Association Professional Practice Committee.","year":"2024","journal-title":"Diabetes Care"},{"key":"2026061714321590900_B14","unstructured":"Centers for Medicare & Medicaid Services.\n          \n          Glucose Monitor - Policy Article. 2024. Accessed 3 July 2024. 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Use of wearable healthcare devices by older adults and their willingness to share health data with providers","volume":"27","author":"Chandrasekaran","year":"2021","journal-title":"Health Informatics J"},{"key":"2026061714321590900_B37","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1093\/tbm\/ibac070","article-title":"Older adults can use technology: why healthcare professionals must overcome ageism in digital health","volume":"12","author":"Mace","year":"2022","journal-title":"Transl Behav Med"},{"key":"2026061714321590900_B38","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.ecl.2019.10.001","article-title":"Benefits and challenges of diabetes technology use in older adults","volume":"49","author":"Toschi","year":"2020","journal-title":"Endocrinol Metab Clin North Am"},{"key":"2026061714321590900_B39","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1097\/MLR.0000000000001216","article-title":"Validity of race and ethnicity codes in Medicare administrative data compared with gold-standard self-reported race collected during routine home health care visits","volume":"58","author":"Jarr\u00edn","year":"2020","journal-title":"Med Care"},{"key":"2026061714321590900_B40","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.2337\/dci23-0021","article-title":"The growing role of technology in the care of older adults with diabetes","volume":"46","author":"Huang","year":"2023","journal-title":"Diabetes Care"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/48\/8\/1377\/814066\/dca250006.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/48\/8\/1377\/814066\/dca250006.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T18:32:30Z","timestamp":1781721150000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/48\/8\/1377\/160547\/Overall-Uptake-and-Racial-Ethnic-and-Socioeconomic"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,30]]},"references-count":40,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,5,30]]},"published-print":{"date-parts":[[2025,8,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dca25-0006","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,30]]}}}