Evidence mapPaperPMID 41918315Full record

ArticleJournal of the American Geriatrics Society2026

Burden and Risk Factors of CGM-Detected Hypoglycemia in Older Adults With Type 2 Diabetes.

Michael Fang, Natalie Rula Daya, Yein Jeon, Justin B Echouffo-Tcheugui, B Gwen Windham, Scott Zeger, Elizabeth Selvin

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Article in Journal of the American Geriatrics Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

7 authors.

Michael FangDepartment of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Natalie Rula DayaDepartment of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.ORCID https://orcid.org/0000-0002-2257-0480
Yein JeonDepartment of Biomedical and Health Informatics, University of Washington, Seattle, Washington, USA.
Justin B Echouffo-TcheuguiDepartment of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
B Gwen WindhamDepartment of Medicine, MIND Center, University of Mississippi Medical Center, Jackson, Mississippi, USA.
Scott ZegerDepartment of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Elizabeth SelvinDepartment of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

Funding

Glucose instability and neurocognitive outcomes in older adultsR01AG074044 · JOHNS HOPKINS UNIVERSITY · 2025 to 2025
$697k
NHLBI NIH HHS K24 HL152440NIA NIH HHS R01 AG074044NIDDK NIH HHS R01 DK128837
6 · The paper itself

Abstract

backgroundComprehensive data on the burden of biochemical hypoglycemia in older adults with type 2 diabetes are lacking. We seek to characterize the burden and risk factors for hypoglycemia detected by continuous glucose monitoring (CGM) in older adults with type 2 diabetes.

methodsA cross-sectional analysis of 315 older adults with type 2 diabetes who attended visit 9 of the Atherosclerosis Risk in Communities Study (2021-2022). We examined rates of Level 1 hypoglycemia (< 70 mg/dL) and percentage meeting recommended targets for hypoglycemia (< 1% of time). We identified risk factors for CGM-detected hypoglycemia by comparing the median time spent in hypoglycemia across subgroups. All analyses were stratified by high-risk medication use (insulin/sulfonylureas vs. not).

resultsOf the 315 participants with type 2 diabetes (mean age 83 years, 55% women, 41% Black adults), 32.4% were using insulin or sulfonylureas. Among individuals using these high-risk medications, the median time spent in hypoglycemia was 3.4%, and ~66% of participants spent more than 1% of the time with CGM glucose < 70 mg/dL. Hypoglycemic episodes typically occurred overnight and lasted a median of ~1.5 h among individuals using insulin or sulfonylureas. CGM-detected hypoglycemia was low in participants not using high-risk medications (median time spent in hypoglycemia: 0.7%). In unadjusted analyses, cardiovascular disease, cognitive impairment, poor physical functioning, and chronic kidney disease were associated with increased time spent in hypoglycemia, regardless of high-risk medication use.

conclusionsThere may be a substantial burden of unrecognized CGM-detected hypoglycemia in very old adults with type 2 diabetes using high-risk medications in the general population. Hypoglycemia may also be present among persons not on high-risk medication, but the burden is much lower. Further research is needed to clarify the clinical significance of these hypoglycemic episodes.

Indexed as

continuous glucose monitoringcorrelates/correlationdiabetes in elderlyglucose monitoring technologieshypoglycemia

Identifiers

PMID41918315
PMCPMC13403248

What Socratic holds

Textmetadata
LicenceTDM
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.