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Background <p>Studies have shown high rates of hypoglycaemia among home-dwelling older people receiving home care services. Hypoglycaemia can lead to severe consequences and in worst case, death. Therefore, knowledge about the factors associated with the occurrence of hypoglycaemia in this patient group is important. This study aimed to investigate the associations between hypoglycaemia and relevant diabetes and age-related factors among individuals with diabetes aged ≥ 65 years who received home care services.</p> Methods <p>This prospective observational study included data from blinded continuous glucose monitoring to identify hypoglycaemia and glycaemic variability. Further, data from blood tests (HbA1c, serum creatinine), medication lists, and questionnaires on cognitive function, functional status with need of assistance, and nutritional status were collected. Data analysis was performed using Fisher’s exact tests and unadjusted logistic regression analyses.</p> Results <p>In total, 56 individuals participated (52% men, median age 82 years). We identified a statistically significant association between hypoglycaemia and glycaemic variability (<i>p</i> &lt; 0.001). All participants with a coefficient of variation (CV) ≥ 36% had undergone at least one hypoglycaemic event during the study period. Also, participants with CV ≥ 27% had higher risk of hypoglycaemia than those with CV &lt; 27% (OR 5.3, 95% CI 1.6, 17.7). Among the 34 participants with HbA1c ≥ 53 mmol/mol, 32% experienced hypoglycaemia. In total, 93% were treated with medications that potentially interfered with the effect of their diabetes medications, and 64% were treated with medications that potentially affected their ability to detect symptoms of hypoglycaemia. The associations between hypoglycaemia and cognitive, functional, or nutritional status is uncertain due to limitations in sample size.</p> Conclusions <p>This study highlights a significant association between glycaemic variability and hypoglycaemia among older home-dwelling adults with diabetes receiving home care services. The prevalence of drug-drug interactions raises concerns about diabetes treatment and emphasise the need for targeted interventions to improve safety and care for this vulnerable group of patients.</p>

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Hypoglycaemia and its associations with diabetes and age-related factors in older home-dwelling people with diabetes

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月15日

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  • Mari Fløde,
  • Monica Hermann,
  • Jannicke Igland,
  • Ingvild Hernar,
  • Arun K. Sigurdardottir,
  • Eirik Søfteland,
  • Anders Åsberg,
  • Trond Geir Jenssen,
  • Anne Haugstvedt

摘要

Background

Studies have shown high rates of hypoglycaemia among home-dwelling older people receiving home care services. Hypoglycaemia can lead to severe consequences and in worst case, death. Therefore, knowledge about the factors associated with the occurrence of hypoglycaemia in this patient group is important. This study aimed to investigate the associations between hypoglycaemia and relevant diabetes and age-related factors among individuals with diabetes aged ≥ 65 years who received home care services.

Methods

This prospective observational study included data from blinded continuous glucose monitoring to identify hypoglycaemia and glycaemic variability. Further, data from blood tests (HbA1c, serum creatinine), medication lists, and questionnaires on cognitive function, functional status with need of assistance, and nutritional status were collected. Data analysis was performed using Fisher’s exact tests and unadjusted logistic regression analyses.

Results

In total, 56 individuals participated (52% men, median age 82 years). We identified a statistically significant association between hypoglycaemia and glycaemic variability (p < 0.001). All participants with a coefficient of variation (CV) ≥ 36% had undergone at least one hypoglycaemic event during the study period. Also, participants with CV ≥ 27% had higher risk of hypoglycaemia than those with CV < 27% (OR 5.3, 95% CI 1.6, 17.7). Among the 34 participants with HbA1c ≥ 53 mmol/mol, 32% experienced hypoglycaemia. In total, 93% were treated with medications that potentially interfered with the effect of their diabetes medications, and 64% were treated with medications that potentially affected their ability to detect symptoms of hypoglycaemia. The associations between hypoglycaemia and cognitive, functional, or nutritional status is uncertain due to limitations in sample size.

Conclusions

This study highlights a significant association between glycaemic variability and hypoglycaemia among older home-dwelling adults with diabetes receiving home care services. The prevalence of drug-drug interactions raises concerns about diabetes treatment and emphasise the need for targeted interventions to improve safety and care for this vulnerable group of patients.