PREVELANCE, RISK FACTORS AND OUTCOMES OF HYPOGLYCEMIA IN ELDERLY DIABETIC PATIENTS

Abstract

Objective: To estimate the clinical outcomes of hypoglycemia in elderly diabetic patients, its associations
with the different antidiabetic drugs and some predisposing factors or comorbid conditions.
Methodology: Both type 1 and type 2 diabetic patients with age 60 years or above fulfilling Whiple's
criteria for hypoglycemia were included in this study. They were collected from the medical unit Hayatabad
Medical Complex Peshawar from November 2010 to July 2011. The patient's history, clinical examination
and investigations were recorded on a proforma. Patients with abnormal CNS findings on CT or MRI scan
and those who didn't give any partial or complete response to the IV glucose, were excluded from the
study.
Results: Eighty five patients with mean age of 75+6 years were included in this study. The average
hospital stay was 10 days. Sixty-five percent (n=55) of these patients were using sulfonylureas, 20%
(n=17) were using metformin alone and in combination, while 25% (n=21) were using insulin
(combination of regular & intermediate acting). Impaired renal function in 40% (n=34), impaired liver
functions in 20% (n=17) and neglected elderly in 30.6% (n=26) were the most common predisposing
factors.
Conclusion: Diabetic treatment related hypoglycemia is more severe in the elderly population with a poor
prognosis. Sulfonylureas are the most frequently associated drugs with poorer outcomes. Predisposing
factors like impaired renal functions, liver functions and neglected elderly increase the frequency of
hypoglycemia. HbA1c is not a good predictor of hypoglycemia in elderly population.