Title

Risk Factors Associated With Severe Hypoglycemia in Older Adults With Type 1 Diabetes.

Document Type

Article

Publication Date

4-1-2016

Publication Title

Diabetes care

Abstract

OBJECTIVE: Severe hypoglycemia is common in older adults with long-standing type 1 diabetes, but little is known about factors associated with its occurrence.

RESEARCH DESIGN AND METHODS: A case-control study was conducted at 18 diabetes centers in the T1D Exchange Clinic Network. Participants were ≥60 years old with type 1 diabetes for ≥20 years. Case subjects (n = 101) had at least one severe hypoglycemic event in the prior 12 months. Control subjects (n = 100), frequency-matched to case subjects by age, had no severe hypoglycemia in the prior 3 years. Data were analyzed for cognitive and functional abilities, social support, depression, hypoglycemia unawareness, various aspects of diabetes management, C-peptide level, glycated hemoglobin level, and blinded continuous glucose monitoring (CGM) metrics.

RESULTS: Glycated hemoglobin (mean 7.8% vs. 7.7%) and CGM-measured mean glucose (175 vs. 175 mg/dL) were similar between case and control subjects. More case than control subjects had hypoglycemia unawareness: only 11% of case subjects compared with 43% of control subjects reported always having symptoms associated with low blood glucose levels (P < 0.001). Case subjects had greater glucose variability than control subjects (P = 0.008) and experienced CGM glucose levels

CONCLUSIONS: In older adults with long-standing type 1 diabetes, greater hypoglycemia unawareness and glucose variability are associated with an increased risk of severe hypoglycemia. A study to assess interventions to prevent severe hypoglycemia in high-risk individuals is needed.

Medical Subject Headings

Aged; Blood Glucose; C-Peptide; Case-Control Studies; Diabetes Mellitus, Type 1; Female; Glycated Hemoglobin A; Humans; Hypoglycemia; Hypoglycemic Agents; Male; Middle Aged; Risk Factors

PubMed ID

26681721

Volume

39

Issue

4

First Page

603

Last Page

610

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