title: Hypoglycemia in older people - a less well recognized risk factor for frailty.
abstract: Recurrent hypoglycemia is common in older people with diabetes and is likely to be less recognized and under reported by patients and health care professionals. Hypoglycemia in this age group is associated with significant morbidities leading to both physical and cognitive dysfunction. Repeated hospital admissions due to frequent hypoglycemia are also associated with further deterioration in patients' general health. This negative impact of hypoglycemia is likely to eventually lead to frailty, disability and poor outcomes. It appears that the relationship between hypoglycemia and frailty is bidirectional and mediated through a series of influences including under nutrition. Therefore, attention should be paid to the management of under nutrition in the general elderly population by improving energy intake and maintaining muscle mass. Increasing physical activity and having a more conservative approach to glycemic targets in frail older people with diabetes may be worthwhile.
authors.affiliation: 1Department of Elderly Medicine, Rotherham General Hospital, England, Moorgate Road, Rotherham, UK.
authors.forename: Ahmed H
authors.initials: AH
authors.lastname: Abdelhafiz
authors.affiliation: 2Hospital Universitario de Getafe, Department of Geriatrics and School of Health Sciences, Universidad Europea de Madrid, Spain.
authors.forename: Leocadio
authors.initials: L
authors.lastname: Rodríguez-Mañas
authors.affiliation: 3Divisions of Geriatric Medicine and Endocrinology, Saint Louis University School of Medicine, St. Louis, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Morley
authors.affiliation: 4Institute of Diabetes for Older People (IDOP), University of Bedfordshire, Luton LU2 8LE, UK.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Sinclair
keywords: frailty; hypoglycemia; old age
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