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Real-World Evaluation of Continuous Glucose Monitoring in Older Adults With Type 2 Diabetes: A Multisite Study of Structures, Processes, and Outcome

Award Number: R01DK147058
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 05/15/2026
PERIOD OF PERFORMANCE END DATE: 02/28/2031

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Real-World Evaluation of Continuous Glucose Monitoring in Older Adults With Type 2 Diabetes: A Multisite Study of Structures, Processes, and Outcome - PROJECT ABSTRACT Type 2 diabetes affects 16.5 million U.S. adults aged ≥65, nearly one-third of the senior population, and is associated with higher rates of hypoglycemia, cardiovascular events, and excess healthcare costs. Continuous glucose monitors (CGMs) offer the potential for improving glycemic control through real-time data, yet CGM adoption and effectiveness remain poorly characterized in older adults. Evidence from trials is limited or inconsistent in this population, and few studies evaluate how clinicians interpret and act on CGM data in routine care, representing a critical gap in addressing therapeutic inertia. This proposal applies a structure-process-outcome framework to evaluate age-related differences in CGM implementation, clinical outcomes, and care processes across two large healthcare systems (Mass General Brigham and the University of California). In Aim 1, we will assess how CGM-derived metrics (e.g., time in range, time below range) influence clinician behavior using mixed-effect models and group-based trajectory modeling to identify glycemic phenotypes linked to treatment decisions. In Aim 2, we will use difference-in-differences and mixed-effect modeling to compare outcomes (HbA1c, blood pressure, LDL, weight, hypoglycemia) and care processes (e.g., medication changes, referrals) between CGM users and non-users across age groups. In Aim 3, we will apply the Consolidated Framework for Implementation Research and rapid ethnography to identify structural and multilevel factors influencing CGM adoption among older adults. This work is innovative in its integration of CGM and EHR data to assess real-world therapeutic inertia, application of trajectory modeling to reveal age-related glycemic patterns, and use of implementation science to identify system-level levers for change. Findings will provide actionable evidence to guide age-responsive CGM implementation strategies, reduce disparities, and improve outcomes for older adults with Type 2 diabetes.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $891,382 )
2026	2026	BRIGHAM & WOMENS HOSPITAL INC	75 FRANCIS ST	BOSTON	MA	02115	SUFFOLK	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	5/12/2026	NEW	$891,382
														Subtotal = $891,382

Grand Total All Awards = $891,382

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Real-World Evaluation of Continuous Glucose Monitoring in Older Adults With Type 2 Diabetes: A Multisite Study of Structures, Processes, and Outcome

Award Number: R01DK147058

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 05/15/2026

PERIOD OF PERFORMANCE END DATE: 02/28/2031

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