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Diabetes Technol Ther. 2016 Dec;18(12):765-771.

Hypoglycemia in Older Adults with Type 1 Diabetes.

Author information

1
1 Jaeb Center for Health Research , Tampa, Florida.
2
2 State University of New York Upstate Medical University , Syracuse, New York.
3
3 Keck School of Medicine of the University of Southern California , Los Angeles, California.
4
4 Northwestern University , Chicago, Illinois.
5
5 International Diabetes Center Park Nicollet , Minneapolis, Minnesota.
6
6 University of South Florida , Tampa, Florida.
7
7 University of North Carolina , Chapel Hill, North Carolina.
8
8 University of Washington , Seattle, Washington.

Abstract

BACKGROUND:

Hypoglycemia is a major concern in older adults with type 1 diabetes (T1D) and there is limited knowledge in this population. We examined data from 199 adults, ≥60 years of age, who participated in a T1D Exchange study assessing factors associated with severe hypoglycemia (SH) in older adults with T1D: 100 with SH in the prior year and 99 with no SH in prior 3 years (mean age 68; mean diabetes duration 40 years; 47% female; 92% non-Hispanic white). Hypoglycemia was assessed with up to 14 days of blinded continuous glucose monitoring (CGM). Linear regression models were performed to assess the association between biochemical hypoglycemia [defined as percentage of time below specific cutoffs (<70/60/50 mg/dL)] and various factors.

RESULTS:

Overall, participants had CGM values <70 mg/dL for a median of 91 min per day. On 53% of days, glucose levels continuously were <70 mg/dL for ≥20 min. Hypoglycemia was found to be strongly associated with glucose variability (r = 0.76; P < 0.001). Time spent in hypoglycemia was greater in those who were younger (P = 0.004), had shorter diabetes duration (P = 0.008), lower HbA1c (P < 0.001), and undetectable C-peptide (P = 0.001), but did not differ by insulin method, education level, number of blood glucose checks per day, cognition, activities of daily living, or fear of hypoglycemia.

INNOVATION:

This study adds valuable data on the frequency of hypoglycemia in older adults with T1D.

CONCLUSION:

Future studies need to focus on how to prevent hypoglycemia in this vulnerable population of older adults with long-standing T1D.

KEYWORDS:

Diabetes management; Hypoglycemia; Older adults; Type 1 diabetes

PMID:
27996319
DOI:
10.1089/dia.2016.0268
[Indexed for MEDLINE]

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