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  • Title: Severe hypoglycaemia leading to hospital admission in type 2 diabetic patients aged 80 years or older.
    Author: Greco D, Pisciotta M, Gambina F, Maggio F.
    Journal: Exp Clin Endocrinol Diabetes; 2010 Apr; 118(4):215-9. PubMed ID: 20072965.
    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.
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