Improving Care for People Living With Dementia and Diabetes: Applying the Human-Centered Design Process to Continuous Glucose Monitoring

Abstract

People with Alzheimer’s disease or related dementias and diabetes mellitus (ADRD-DM) are at high risk for hypoglycemic events. Their cognitive impairment and psychosocial situation often hinder detection of hypoglycemia. Extending use and benefits of continuous glucose monitoring (CGM) to people with ADRD-DM could improve hypoglycemia detection, inform care, and reduce adverse events. However, cognitive impairment associated with ADRD presents unique challenges for CGM use. This commentary proposes applying the human-centered design process to CGM, investigating design solutions or interventions needed to integrate CGM into the health care of patients with ADRD-DM. With this process, we can identify and inform CGM designs for people with ADRD-DM, broadening CGM access, increasing detection and treatment of the silent threat posed by hypoglycemia.

Overcoming barriers to technology in special groups

“…Nevertheless, concerns regarding CGM use in those with impaired cognition remain (Figure 2). 34 CGM has been well tolerated by those with mild cognitive impairment 35 and patients and carers report a flash device did not interfere with sleep or daily activities. 33 However, the latter small study saw only onethird of participants reaching ≥70% data capture.…”