High number of hypoglycaemic episodes identified by CGM among home-dwelling older people with diabetes: an observational study in Norway

BMC Endocrine Disorders

Research

Anne Haugstvedt¹  Mari Fløde¹  Monica Hermann¹  Marit Graue¹  Jannicke Igland²  Eirik Søfteland³  Anders Åsberg⁴  Trond Geir Jenssen⁵ 

[1] Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway;Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway;Department of Medicine, Haukeland University Hospital, Bergen, Norway;Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway;Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway;Department of Medicine, Haukeland University Hospital, Bergen, Norway;Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway;Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway;Department of Pharmacy, Section for Pharmacology and Pharmaceutical Biosciences, University of Oslo, Oslo, Norway;Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway;Institute of Clinical Medicine, University of Oslo, Oslo, Norway;

关键词: Diabetes;    Older people;    Hypoglycaemia;    Home care;    Clinical pharmacology;    Drug safety;   

DOI  :  10.1186/s12902-023-01472-6

 received in 2023-04-22, accepted in 2023-09-28,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundA scoping review from 2021 identified a lack of studies on the incidence, prevention and management of hypoglycaemia in home-dwelling older people with diabetes. The aim of this study was to investigate the frequency and duration of hypoglycaemic episodes measured by continuous glucose monitoring (CGM) in older people with diabetes who received home care and who were treated with glucose-lowering medications, and to compare the frequency and duration of hypoglycaemic episodes between subgroups of the study population according to demographic and clinical variables.MethodsThis was an observational study investigating the occurrence of hypoglycaemia in people with diabetes aged ≥ 65 years. Data were collected using blinded continuous glucose monitoring (CGM, iPro2) for 5 consecutive days. Frequency and duration of hypoglycaemic episodes were assessed using a sensor glucose cut-off value of 3.9 mmol/L. A blood sample for measurement of HbA1c and creatinine-based eGFR (CKD-EPI) was obtained during the monitoring period. Demographic and clinical data were collected from electronic patient records.ResultsFifty-six individuals were enrolled (median age 82 years and 52% were men). Of the 36 participants who were treated with insulin, 33% had at least one hypoglycaemic episode during the five-day period. Among 18 participants who neither used insulin nor sulfonylurea, but other glucose-lowering medications, 44% had at least one hypoglycaemicepisode. Of those with hypoglycaemic episodes, 86% lived alone. The median duration of the hypoglycaemia was 1 h and 25 min, ranging from 15 min to 8 h and 50 min.ConclusionThis study identified an unacceptably high number of unknown hypoglycaemic episodes among older home-dwelling people with diabetes receiving home care, even among those not using insulin or sulfonylurea. The study provides essential knowledge that can serve as a foundation to improve the treatment and care for this vulnerable patient group. The routines for glucose monitoring and other prevention tasks need to be considered more comprehensively, also, among those treated with glucose-lowering medications other than insulin.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 1