PREVELANCE, RISK FACTORS AND OUTCOMES OF HYPOGLYCEMIA IN ELDERLY DIABETIC PATIENTS

Objective: To estimate the clinical outcomes of hypoglycemia in elderly diabetic patients, its associationswith the different antidiabetic drugs and some predisposing factors or comorbid conditions.Methodology: Both type 1 and type 2 diabetic patients with age 60 years or above fulfilling Whiple scriteria for hypoglycemia were included in this study. They were collected from the medical unit HayatabadMedical Complex Peshawar from November 2010 to July 2011. The patient s history, clinical examinationand investigations were recorded on a proforma. Patients with abnormal CNS findings on CT or MRI scanand those who didn t give any partial or complete response to the IV glucose, were excluded from thestudy.Results: Eighty five patients with mean age of 75+6 years were included in this study. The averagehospital stay was 10 days. Sixty-five percent (n=55) of these patients were using sulfonylureas, 20%(n=17) were using metformin alone and in combination, while 25% (n=21) were using insulin(combination of regular intermediate acting). Impaired renal function in 40% (n=34), impaired liverfunctions in 20% (n=17) and neglected elderly in 30.6% (n=26) were the most common predisposingfactors.Conclusion: Diabetic treatment related hypoglycemia is more severe in the elderly population with a poorprognosis. Sulfonylureas are the most frequently associated drugs with poorer outcomes. Predisposingfactors like impaired renal functions, liver functions and neglected elderly increase the frequency ofhypoglycemia. HbA1c is not a good predictor of hypoglycemia in elderly population.