Feature Article

Hypoglycemia in the elderly

Suzy V Hope and W David Strain

Diabetic Hypoglycemia June 2013, Volume 6, Issue 1: page 3-10

Abstract

Hypoglycemia is a common, under-recognized complication of the management of type 2 diabetes. Elderly individuals have a higher burden of co-morbidities, cognitive impairment, physical dysfunction and frailty, which makes them more vulnerable to complications of hypoglycemia, such as falls, fractures, cognitive impairment and cardiovascular events, than younger patients. Furthermore, with ageing comes impairment of autoregulatory responses, which means the symptoms of hypoglycemia are often less specific, and are therefore either missed or incorrectly diagnosed as transient ischemic attacks or other cerebrovascular events. Older adults with diabetes have a greater risk of hypoglycemia associated with the physiological decline of ageing, and the extended duration of diabetes and insulin treatment. The elderly are also more prone to the effects of hypoglycemia such as the increased risk of accidents, falls and fractures, hospitalizations, in-hospital mortality, and long-term impairment of cognition. Using individualized treatment targets to base treatment strategies around individual circumstances may reduce the risk of hypoglycemia.

Keywords: diabetes, elderly people, hypoglycemia