Severe hypoglycemia in the elderly diabetes

ABSTRACT

BACKGROUND: Hypoglycemia is the most common therapeutic complication of diabetes mellitus and especially in elderly diabetic patients with diminished cardiac and cerebral circulation can cause serious tissue damage. Though many studies have attempted to evaluate hypoglycemia in IDDM or adult diabetic patients, few studies in the elderly. We have compared clinical characteristics of severe hypoglycemia in elderly diabetes with adult diabetes. METHODS: This study include 56 severe hypoglycemic patients who have admitted to emergency department of National Medical Center from march 1, 1992 to december 31, 1997. they are divided two group (adult group; 21, elderly group; 35) and authors investigate the cause, the symptom, the time of severe hypoglycemia, degree of education, treatment method in each group. RESULTS: 1) DM education was not well done in severe hypoglycemic patients. 2) The frequency of severe hypoglycemia in the elderly was more than adult (adult 21 (38%), elderly 35 (62%)). 3) In both population, the most common symptom of severe hypoglycemia was neuroglycopenic symptom, especially in the elderly (adult 57%, elderly 77%). 4) Decreased food intake (49%) in the elderly and overdose of insulin (38%) in the adult were the most common cause of severe hypoglycemia. 5) Severe hypoglycemia occurred more often between midnight and 6 AM in the adult, between noon and 6 PM in the elderly. 6) The treatment of diabetes mellitus is insulin (71%) and oral hypoglycemic agent (29%) in the adult, oral hypoglycemic agent (51%) and insulin (49%) in the elderly. CONCLUSION: For prevention of severe hypoglycemia, we should emphasize the importance of DM education and especially elderly diabetic patients should be educated about the symptoms of hypoglycemia, the self-management of hypoglycemia, the need for a regular carbohydrate intake and more easy and effective diet program is require in elderly diabetes.