This research examines the usability, effectiveness, and involvement of Continuous Glucose Monitoring (CGM) systems in the Remote Patient Monitoring (RPM) platform for elderly people with Type 2 Diabetes Mellitus (T2DM). With the rise of global populations, along with the rise in chronic illnesses such as diabetes, it is an increasingly pressing need that technological solutions are both effective and accessible for older adults. CGM technology provides glucose tracking in real time, with improved glycaemic control and less invasive finger-prick testing. However, adoption among elderly users is not uniform as age-related issues, such as dexterity, cognitive decline, and digital illiteracy, continue to be challenging. This research explores the way older adults use the CGM systems, device usability, engagement behaviours, and therapeutic effects. In a quantitative, survey-based approach, the study gathers and reviews data from CGM users from the aging population, caregivers, and healthcare providers. Key findings indicate that while CGM systems can dramatically change glycaemic management and patient autonomy, usability problems related to complex interface usage and trouble with insertion of the sensor create important barriers. Engagement levels differ, and long-term adherence is frequently interfered with by the presence of alert fatigue, cost, and inadequate training. Besides listing reasons such as psychological, technical, and financial, hindering successful CGM adoption, the study proposes strategies to boost CGM user engagement and retention. These are easy-to-use interface designs, customization of alert settings, constant education, caregiver support, and enhanced insurance coverage. Statistical findings prove that there is a correlation between CGM use and improved glycaemic results, especially with those systems tailored to the physical and cognitive needs of elderly users. Finally, the study makes a contribution to the emerging field of digital health by providing evidence-based recommendations for the design and delivery of CGM technologies for aging populations. It illustrates the need for health tech solutions that are inclusive and relevant in elderly patients’ care in remote and digitally-enabled healthcare ecosystems.