September 12, 2025
4 min read
Key takeaways:
- Older adults with diabetes face unique barriers when initiating diabetes devices.
- Health care professionals should make adjustments to diabetes technology to tailor to the needs of older patients.
Health care professionals should take an individualized approach when prescribing diabetes technology for older adults and devise strategies that best fit each person’s needs, according to three presenters.
During a session at the Association of Diabetes Care & Education Specialists annual meeting, two diabetes care and education specialists and a patient with type 1 diabetes for more than 60 years discussed barriers older adults with diabetes face with using diabetes devices. The speakers highlighted features or tools with devices that can help older adults overcome these barriers and emphasized the role of a strong support system in helping older adults use technology.
“What matters to [older adults] is improved quality of life,” Christina R. Whitehouse, PhD, AGPCNP-BC, CDCES, FADCES, associate professor in the Fitzpatrick College of Nursing at Villanova University, said during a presentation. “We want individuals to live to their maximum potential, and how we can help them as educators is to give them the tools to do that.”
Recommendations on technology use
Focusing on technology use is necessary for older adults due to the rising number in that population with diabetes. Nancy A. Allen, PhD, ANP-BC, FADCES, FAAN, professor at University of Utah College of Nursing, said of all U.S. adults with diabetes, 29% are aged 65 years and older.
“We also know that we have fewer than 7,300 board-certified geriatricians in the U.S. to care for this population,” Allen said during a presentation. “We only have between 5,000 and 6,000 endocrinologists, and the population of older adults with diabetes is only growing.”
A multitude of age-related changes could impact an older adult’s ability to use technology, including cognitive decline, physical changes, sensory shifts such as visual impairment or touch sensitivity, anxiety or low self-efficacy with using technology and social and environmental factors.
“There are also age-related glucose changes and an increased risk of hypoglycemia,” Allen said. “This is due to a decreased production of the counter-regulatory hormones and autonomic neuropathy. … This often leads to unrecognized symptoms of hypoglycemia.”
The American Diabetes Association Standards of Care includes a chapter centered on older adults with diabetes. Allen discussed some of the recommendations, which include performing a full health assessment of older adults to determine diabetes management goals. The Standards also recommend screening older adults annually for geriatric symptoms, hypoglycemia and polypharmacy.
In the hypoglycemia recommendations for older adults, Allen noted that the Standards of Care recommend the use of continuous glucose monitoring for those with type 1 diabetes, and state health care professionals should offer CGM to older adults with type 2 diabetes who use insulin. Additionally, the Standards state automated insulin delivery systems and other advanced insulin delivery devices should be considered for older adults “based on individual ability and support system.”
Strategies for using diabetes devices
Whitehouse said factors such as hypoglycemia prevention and improved quality of life are reasons that enable diabetes technology to be implemented in older adults. Guidance from a diabetes care and education specialist, family support and peer support can also help older adults. Whitehouse added that diabetes technology can be introduced gradually, and some systems include user-friendly interfaces.
Whitehouse said health care professionals also need to be aware of potential barriers, including technology anxiety, cost concerns, physical limitations, cognitive challenge, transitions in care and inadequate training and support.
“If you don’t address those barriers for those patients, they’re not going to be able to put [diabetes technology] into place,” Whitehouse said.
Health care professionals can implement several strategies to ease the implementation and use of blood glucose monitors, CGMs and insulin pumps for older adults. Whitehouse listed several potential interventions for each device, including using a visual display device for older adults with hearing loss, enabling background lights and other visual aids for those with hearing loss, and utilizing grip aides or strips for older adults who struggle with dexterity. Diabetes devices can transmit or provide data automatically to assist older adults with cognitive impairment. Additionally, Whitehouse noted care partners can play a key role in assisting older adults using any diabetes device.
“You want to make something very simple for older adults,” Whitehouse said.
Patient-recommended suggestions
Joanne Milo, MBA, a patient with type 1 diabetes for more than 60 years, talked about how insulin pumps, CGM and automated insulin delivery have greatly benefited her and other older adults with diabetes, but shared that there are additional improvements device companies and health care professionals could take to assist this population.
Milo recommended the creation of cheat sheets or mobile apps to help device users with routine tasks, new research to explore solutions for device-related skin issues, and improvements in user-controlled volume alerts and tools to address hearing and vision loss. Milo also said companies should devise ways to assist older adults with dexterity with rubber holders, improvements with syringes, prefilled cartridges of insulin and varying shapes and colors for different vials.
Milo said older adults need trained health care professionals and recommended the creation of a registry of diabetes care and education specialists, nurses and physical assistants to assist patients with finding support. She added there is also a need for diabetes care and education specialists who are trained in analyzing diabetes device data and making glycemic management adjustments based on the numbers. Milo said older adults could also use more education on hypoglycemia treatments and simpler steps for performing device-related tasks.
Milo said there is a need for older adults with diabetes to share their experiences with health care professionals and others with the disease. She recommended the creation of a counseling hot line for older adults, the development of a buddy system with other older adults with type 1 diabetes and moderated online video discussions.
“We’ve been trying to make communities,” Milo said. “Zoom events are wonderful. If [they include] education and people can talk, patients develop their own networks.”
Reference:
Sources/Disclosures
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Allen NA, et al. Presentation F15. Presented at: ADCES25; Aug. 8-11, 2025; Phoenix.
Disclosures:
Allen reports receiving a research grant from Dexcom. Milo and Whitehouse report no relevant financial disclosures.
