Severe Hypoglycaemia Leading to Hospital Admission in Type 2 Diabetic Patients Aged 80 Years or Older

Exp Clin Endocrinol Diabetes. 2010 Apr;118(4):215-9. doi: 10.1055/s-0029-1241823. Epub 2010 Jan 12.

Abstract

Aim: Evidence is mounting that hypoglycaemia among elderly diabetic patients is a very real and costly concern. Objective of this study was to determine the incidence and risk factors for developing severe hypoglycaemia leading to hospital admission, among type 2 diabetic subjects aged 80 years or older.

Methods: Hypoglycaemia was defined as a symptomatic event requiring treatment with i. v. glucose and confirmed by a blood glucose determination <50 mg/dl.

Results: During a eight-year period severe hypoglycaemia was identified in 99 subjects. These patients were found to have a reduced cognitive ability, a heavy burden of comorbid disease and a HbA1c values of 5.9%. Of the hypoglycaemic episodes, 76 occurred in patients taking glibenclamide. Diabetes therapy was prescribed by general practitioners in 85 of them. Only 26 patients performed regular home blood glucose self-monitoring.

Conclusion: Severe hypoglycaemia is a serious and not uncommon metabolic emergency among patients with type 2 diabetes aged 80 years or older; it is more frequent in patients with considerable comorbidity undergoing aggressive diabetes management and in users of a long-acting sulphonylurea. In elderly subject, each patient's risk for hypoglycaemia should be considered and therapy should be individualized accordingly; in our opinion, a great number of episodes may be avoided by teaching the principles of blood glucose monitoring and involving general practitioners in outpatients management of diabetes mellitus.

MeSH terms

  • Aged, 80 and over
  • Blood Glucose Self-Monitoring
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Female
  • Glucose / therapeutic use
  • Glyburide / adverse effects*
  • Hospitalization
  • Humans
  • Hypoglycemia / blood
  • Hypoglycemia / chemically induced*
  • Hypoglycemia / drug therapy
  • Hypoglycemia / epidemiology*
  • Hypoglycemic Agents / adverse effects
  • Incidence
  • Male
  • Patient Admission
  • Risk Factors

Substances

  • Hypoglycemic Agents
  • Glucose
  • Glyburide