Eficacia y seguridad de la tecnología en diabetes en el adulto mayor: Una revisión narrativa

Background: As the general population ages, the prevalence of chronic non-communicable diseases such as diabetes mellitus (DM) increases. With the improvement in treatments for diabetes, it has been possible to reduce the rate of complications related to the disease and prolong the life expectancy of these patients; therefore, we will increasingly have more elderly patients living with diabetes. Older adults are a heterogeneous group of patients, with wide differences in comorbidities, physical and cognitive abilities. Furthermore, they have certain characteristics that make them more vulnerable to experiencing episodes of hypoglycemia, which significantly increase their risk of morbidity and mortality for a long period of time.Purpose: To summarize the evidence in the literature about the safety and effectiveness of the use of continuous glucose monitoring and insulin pumps in the elderly population with diabetes, in terms of glycemic control and risk of hypoglycemia. To identify the gaps in knowledge that exist about the use of this technology in the elderly population.Methodology: To carry out the literature search, databases such as PubMed, GoogleScholar and Trip were used, using keywords such as “elderly”, “older adults”, “aged”, “continuous glucose monitoring”, “insulin pump”, “hypoglycemia”, “glucose control”. Articles identified as relevant were included in this narrative review.Results: Continuous glucose monitoring and insulin pumps are safe and effective tools in the treatment of DM in older adults; They allow adequate metabolic control and reduce the risk of hypoglycemia, especially closed-loop systems. These benefits appear to also extend to quality of life.Conclusions: Insulin pumps are effective and safe in the elderly, especially last generation devices. More studies are needed to evaluate whether the benefits in metabolic control and reduced risk of hypoglycemia extend to populations with a high disease burden; as well as cost-effectiveness studies to evaluate whether this treatment can be implemented widely and massively.