Frequent hypoglycemia among elderly patients with poor glycemic control
| Autor: | Richard L. McCartney, Laura Desrochers, Alissa R. Segal, Yishan Lee, Adrianne Sternthal, Elizabeth Staum, Medha Munshi, Judy Giusti, Katie Weinger, Patricia Bonsignore, Emmy Suhl |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Blood Glucose
medicine.medical_specialty Pediatrics endocrine system diseases medicine.medical_treatment Population Hypoglycemia Insulin resistance Blood Glucose Self-Monitoring Diabetes mellitus Internal Medicine medicine Humans education Aged Aged 80 and over Glycated Hemoglobin education.field_of_study business.industry Insulin nutritional and metabolic diseases Type 2 Diabetes Mellitus medicine.disease Surgery Hemoglobin A Diabetes Mellitus Type 2 business |
| Zdroj: | Archives of internal medicine. 171(4) |
| ISSN: | 1538-3679 |
| Popis: | Episodes of hypoglycemia are particularly dangerous in the older population. To reduce the risk of hypoglycemia, relaxation of the standard hemoglobin A(1c) (HbA(1c)) goals has been proposed for frail elderly patients. However, the risk of hypoglycemia in this population with higher HbA(1c) levels is unknown.Patients 69 years or older with HbA(1C) values of 8% or greater were evaluated with blinded continuous glucose monitoring for 3 days.Forty adults (mean [SD] age, 75 [5] years; HbA(1C) value, 9.3% [1.3%]; diabetes duration, 22 [14] years; 28 patients [70%] with type 2 diabetes mellitus; and 37 [93%] using insulin) were evaluated. Twenty-six patients (65%) experienced 1 or more episodes of hypoglycemia (glucose level70 mg/dL). Among these, 12 (46%) experienced a glucose level below 50 mg/dL and 19 (73%), a level below 60 mg/dL. The average number of episodes was 4; average duration, 46 minutes. Eighteen patients (69%) had at least 1 nocturnal episode (10 pm to 6 am). Of the total of 102 hypoglycemic episodes, 95 (93%) were unrecognized by finger-stick glucose measurements performed 4 times a day or by symptoms.Hypoglycemic episodes are common in older adults with poor glycemic control. Raising HbA(1C) goals may not be adequate to prevent hypoglycemia in this population. |
| Databáze: | OpenAIRE |
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