Diabetes Technology Across the Lifespan of People With Diabetes (Ages 2-88 Years): Insights From the dt-Report on Usage Trends Across all Age Groups

Abstract

Background:

The number of adults with diabetes and older age is increasing, yet little is known about age-related differences in real-world diabetes technology use. This analysis examines how uptake, clinical outcomes, and user experience vary across age groups in people with type 1 or type 2 diabetes.

Methods:

Self-reported data from 2056 individuals with diabetes in Germany, Austria, and Switzerland who completed the diabetes technology report 2024/2025 survey were analyzed. Age-related trends in the use of continuous glucose monitoring (CGM), continuous subcutaneous insulin infusion (CSII), and automated insulin delivery (AID) were assessed using generalized additive and segmented logistic regression models. Outcomes included HbA1c, diabetes distress (PAID-5), severe hypoglycemia (SH), and, among AID users, satisfaction.

Results:

Among people with type 1 diabetes, CGM usage was consistently high across age groups (eg, 94% in 20-29 years; 92% in ≥70 years). Automated insulin delivery usage peaked in adolescents (81% in 10-19 years) and declined to 36% in adults ≥70 years. In type 2 diabetes, CGM use increased with age (48% in 35-44 years; 72% in ≥70 years). The HbA1c remained stable over the age span (±0.25%). Diabetes distress declined with age (Problems Areas in Diabetes Ouestionnaire – 5 Items (PAID-5): 7.8 in <30 vs 4.2 in ≥70 years). The risk of SH did not increase with age; among CSII users, older participants had lower odds of SH (OR 0.03, p = .001). Automated insulin delivery satisfaction was highest in adults aged 60 to 69 years (88.7/100) and lowest in adolescents (79.1/100).

Conclusions:

Diabetes technologies are widely used and well tolerated across age groups. Older adults benefit comparably, but barriers to AID use remain.