Older Diabetes Patients Often Unaware of Hypoglycemia

By Megan Brooks

April 03, 2019

NEW YORK (Reuters Health) - Older adults with type 1 diabetes typically spend more than an hour a day in the hypoglycemic range, while those who aren't aware their blood sugar is low can spend more than 100 minutes a day in the hypoglycemic range, a new study suggests.

"The consequences of hypoglycemia, particularly in older individuals, can be devastating," and unawareness of hypoglycemia remains a "major issue" for older patients with diabetes, said lead researcher Dr. Anders Carlson, Medical Director of the International Diabetes Center in Minneapolis, Minnesota, during a media briefing at the Endocrine Society's annual meeting in New Orleans.

The study team analyzed blinded continuous glucose monitoring (CGM) data collected at baseline in a randomized trial assessing the effect of CGM on hypoglycemia in 203 adults aged 60 and older with type 1 diabetes.

Overall, the data suggest that patients spend about 72 minutes per day in hypoglycemia (blood glucose <70 mg/dL) and about 24 minutes per day in "dangerously" low blood glucose (<54 mg/dL), Dr. Carlson reported.

Having impaired awareness of low blood sugar was associated with greater time spent with glucose levels <70 mg/dL (101 min/day) and <54 mg/dL (43 min/day).

Overall, older adults spent 57% of time in target glucose range of 70 to 180 mg/dL (13.7 hours per day), about 35% of time in hyperglycemia (above 180 mg/dL, 8.4 hours per day), and about 12% of time in severe hyperglycemia (above 250 mg/dL, 2.8 hours per day), Dr. Carlson reported.

Being retired (versus employed or unemployed) was associated with more time spent in target glucose range. Retired adults also spent less time in hyperglycemia or severe hyperglycemia. A lower total daily dose of insulin was associated with more time in range.

Summing up, Dr. Carlson said hypoglycemia remains a "major barrier" to optimal glycemic management in older adults with type 1 diabetes and interventions to improve time in range and reduce hypoglycemia are needed in these patients.

SOURCE: http://bit.ly/2YCVP0P

The Endocrine Society 2019 Annual Meeting