Severe hypoglycaemia leading to hospital admission in type 2 diabetic patients aged 80 years or older.
OBJECTIVE
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.


CONCLUSIONS
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.
Greco
D
D
Division of Diabetology. S. Biagio Hospital - Marsala (TP), Italy. drgreco@alice.it
Pisciotta
M
M
Gambina
F
F
Maggio
F
F
D000369:Aged, 80 and over; D015190:Blood Glucose Self-Monitoring; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy; D005260:Female; D005947:Glucose / Q000627:therapeutic use; D005905:Glyburide / Q000009:adverse effects*; D006760:Hospitalization; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000139:chemically induced* / Q000188:drug therapy / Q000453:epidemiology*; D007004:Hypoglycemic Agents / Q000009:adverse effects; D015994:Incidence; D008297:Male; D010343:Patient Admission; D012307:Risk Factors
D007004:Hypoglycemic Agents; D005947:Glucose; D005905:Glyburide