Study of hypoglycemia in elderly diabetes mellitus

Background: The etiology of diabetes in India is multifactorial and includes genetic factors coupled with environmental influences such as obesity associated with rising living standards, steady urban migration, and lifestyle changes. It is a chronic disease, and as it prolongs it has many serious effects on multiple organs of the body. Keeping a view of the above-said problem, there arises a need for rigorous control of diabetes mellitus. However, rigorous control of diabetes leads to more incidence of hypoglycemia in elderly diabetic patients. Hypoglycemia has serious complications leading to various morbidity and mortality. Aim and objective: To study the risk factors associated with the development of hypoglycemia in elderly diabetic patients, to study about the symptoms occurring during the hypoglycemic episodes. Materials and methods: The study included 100 patients: Group –A 50 diabetics and Group B controls. Age and sex-matched diabetic patients >60 years admitted during the same period in RMMCH. Details of the hypoglycemic episode (symptoms, severity, glucose level, risk factors identified, treatment and outcome), comorbidities, polypharmacy, alcohol use and assessment of functional status Assessment of the functional status was done using Katz score. Results: Functional status of patients were assessed with KATZ index only 10 out of 50 study patients had poor (Katz score=0) functional status. 52% patients had their episodes during night time. 34 patients (68%) had come to the hospital with hypoglycemia and the rest of the patients developed hypoglycemia in-hospital stay. 70% of patients had symptoms and 30% had no symptoms. Neuroglycopenia was predominant in most patients. Conclusion: Asymptomatic hypoglycemia was common in the elderly diabetics. In symptomatic patients, neuroglycopenic symptoms were more commonly encountered than autonomic symptoms. The mean duration of diabetes mellitus was longer in the group of study patients with no symptoms of hypoglycemia as compared to patients who were symptomatic for hypoglycemia.