PMID- 15163121
OWN - NLM
STAT- MEDLINE
DCOM- 20040930
LR  - 20221207
IS  - 0394-3402 (Print)
IS  - 0394-3402 (Linking)
VI  - 17
IP  - 1
DP  - 2004 Feb
TI  - Drug-induced severe hypoglycaemia in Type 2 diabetic patients aged 80 years or 
      older.
PG  - 23-6
AB  - Our knowledge about the risk of hypoglycaemia associated with diabetes treatment 
      is derived from studies that often exclude elderly people. Aim of this study was 
      to determine the incidence and risk factors for developing severe hypoglycaemia 
      among persons aged 80 yr or older, with Type 2 diabetes mellitus (T2DM). During a 
      2-yr period, all episodes of severe hypoglycaemia occurred in T2DM patients aged 
      80 yr or older were identified. Hypoglycaemia was defined as a symptomatic event 
      requiring treatment with i.v. glucose and confirmed by a blood glucose 
      determination of less than 50 mg/dl. A detailed history and blood laboratory 
      profile were obtained for each patient. During the period of the survey a total 
      of 124 diabetic subjects aged 80 yr or older were hospitalised and severe 
      hypoglycaemia was reported in 31 patients (25%). This group of patients had a 
      marked comorbidity and was found to have HbA1c values of 5.1% indicating that 
      their diabetes was well controlled. Of these hypoglycaemic episodes, 23 (74%) 
      occurred in patients taking glibenclamide. Diabetes therapy was prescribed by 
      general practitioners in 24 of these patients. Seventeen subjects concomitantly 
      received drugs that potentiated hypoglycaemia. Only 10 patients performed regular 
      blood glucose self-monitoring. In conclusion, severe hypoglycaemia is a serious 
      and not uncommon problem among elderly patients with T2DM; it is more frequent in 
      patients undergoing aggressive diabetes management and in users of a long-acting 
      sulphonylurea (eg, glibenclamide). A normal HbA1c level in this age group appears 
      to be a powerful indicator of the risk of severe hypoglycaemia and should alert 
      clinicians to change therapy. Finally, each patient's risk for hypoglycaemia 
      should be considered and therapy should be individualised accordingly; in our 
      opinion, a great number of episodes of serious hypoglycaemia may be prevented by 
      teaching the principles of blood glucose monitoring and involving general 
      practitioners in outpatient management of diabetes mellitus in the elderly.
FAU - Greco, D
AU  - Greco D
AD  - Division of Diabetology, S. Biagio Hospital, Marsala, TP, Italy. 
      mimmogreco@interfree.it
FAU - Angileri, G
AU  - Angileri G
LA  - eng
PT  - Journal Article
PL  - Italy
TA  - Diabetes Nutr Metab
JT  - Diabetes, nutrition & metabolism
JID - 8813443
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Sulfonylurea Compounds)
RN  - SX6K58TVWC (Glyburide)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Blood Glucose/analysis
MH  - Blood Glucose Self-Monitoring
MH  - Diabetes Mellitus, Type 2/blood/*drug therapy
MH  - Female
MH  - Glyburide/adverse effects/therapeutic use
MH  - Glycated Hemoglobin/analysis
MH  - Humans
MH  - Hypoglycemia/*chemically induced/epidemiology
MH  - Hypoglycemic Agents/*adverse effects/therapeutic use
MH  - Incidence
MH  - Male
MH  - Prospective Studies
MH  - Risk Factors
MH  - Sulfonylurea Compounds/adverse effects/therapeutic use
EDAT- 2004/05/28 05:00
MHDA- 2004/10/01 05:00
CRDT- 2004/05/28 05:00
PHST- 2004/05/28 05:00 [pubmed]
PHST- 2004/10/01 05:00 [medline]
PHST- 2004/05/28 05:00 [entrez]
PST - ppublish
SO  - Diabetes Nutr Metab. 2004 Feb;17(1):23-6.