Continuous glucose monitoring system signals the occurrence of marked postprandial hyperglycemia in the elderly.
BACKGROUND
The aim of this study was to ascertain whether dysglycemic episodes occur in institutionalized elderly persons and, if that is the case, to determine whether such episodes are related to meal patterns. Another objective was to investigate the feasibility of subcutaneous (s.c.) glucose measurements in the elderly using a Medtronic MiniMed (Sylmar, CA) continuous glucose monitoring system (CGMS).


METHODS
Nine nursing home residents (74-95 years old) without known diabetes or other metabolic disorders were included. The s.c. glucose level was measured for 3 days with the Medtronic MiniMed CGMS. Capillary blood glucose was measured four times daily with a Glucometer Elite device (Bayer, Leverkusen, Germany). Body mass index and basal metabolic rate were calculated, and food intake was recorded.


RESULTS
The s.c. glucose level fluctuated noticeably over time; 22.5% of the values recorded during the 3-day period were > or = 8 mmol/L, and values < 3.5 mmol/L were rarely seen. A marked (> 5 mmol/L) and short-term (2-4 h) increase in s.c. glucose was seen after a meal. The mean capillary blood glucose concentration was 7.5 +/- 1.8 mmol/L. Capillary blood glucose > or = 8 mmol/L was recorded on 32.5% of the measurement occasions, and no values were < 3.5 mmol/L. The s.c. glucose values agreed with corresponding capillary blood glucose levels (mean r = 0.75; range 0.43-0.86). Five participants consumed less energy than recommended according to their age, weight, and physical activity level.


CONCLUSIONS
Postprandial hyperglycemia frequently occurs in elderly people living in nursing homes. The CGMS is convenient to use to detect hyperglycemia in this age group.
Jamali
Reza
R
Division of Cell Biology, Department of Biomedicine and Surgery and Diabetic Research Centre, Linköping University, Linköping, Sweden.
Bachrach-Lindström
Margareta
M
Mohseni
Simin
S
D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D015930:Diet Records; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis / Q000453:epidemiology*; D007258:Informed Consent; D008297:Male; D018670:Monitoring, Ambulatory / Q000379:methods*; D009735:Nursing Homes; D019518:Postprandial Period; D015203:Reproducibility of Results
D001786:Blood Glucose