Novel use of continuous glucose monitoring device to enhance glycaemic control in a poorly adherent patient with type 2 diabetes and vascular dementia in an aged care facility
Regis East Malvern, 400 Waverley Road, Malvern East Victoria 3145, Australia.
Research Article
Open Access Research Journal of Medical and Clinical Case Reports, 2026, 04(01), 001-003.
Article DOI: 10.53022/oarjmccr.2026.4.1.0012
Publication history:
Received on 24 December 2025; revised on 10 February 2026; accepted on 12 February 2026
Abstract:
Older adults with type 2 diabetes mellitus (T2DM) and cognitive impairment present significant challenges for safe glycaemic management in residential aged care settings. We describe the case of a 73-year-old woman with T2DM, vascular dementia, ischaemic heart disease and chronic kidney disease, who experienced marked glycaemic variability and poor adherence to capillary blood glucose monitoring (BGM). Her diabetes was managed with linagliptin and basal insulin; however, refusal of finger-prick testing, dietary non-adherence, and monitoring-related anxiety limited detection of hypo- and hyperglycaemia. Blood glucose levels fluctuated widely from 4.8 to 27.8 mmol/L, contributing to fatigue, anxiety, hyperglycaemia-related polyuria, and increased falls risk.
Continuous glucose monitoring (CGM) devices are commonly used for type 1 diabetes mellitus in Australia as they are fully subsidised through the National Diabetes Service Scheme (NDSS). However, usage is low in T2DM due to limited subsidies. Therefore, a novel use of a CGM device, FreeStyle Libre 2 Plus sensorTM, was introduced following multidisciplinary consultation involving the patient, general practitioner, nursing staff, and family. Nursing staff were trained in device use and alarm-based responses, with thresholds set for hypoglycaemia and hyperglycaemia. CGM trend data enabled safer medication titration, including addition of modified release gliclazide, resulting in reduced hyperglycaemic episodes and improved time within target glucose range. Nursing staff reported increased confidence and timely interventions, while the patient experienced improved energy and confidence.
Despite funding barriers and limited evidence, CGM proved a feasible and minimally intrusive strategy for improving glycaemic control in a poorly adherent aged care resident.
Keywords:
Continuous Glucose Monitoring; Residential Aged Care; Dementia; Technology Assisted; Type 2 Diabetes Care
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Copyright © 2026 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0