Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates.
Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
PLoS One. 2024 Aug 29;19(8):e0309618. doi: 10.1371/journal.pone.0309618. eCollection 2024.
The prevalence of type 2 diabetes (DM) has been increasing globally, particularly among older adults who are more susceptible to DM-related complications. Elderly individuals with diabetes are at higher risk of developing hypoglycemia compared with younger diabetes patients. Hypoglycemia in elderly patients can result in serious consequences such as cognitive changes, increased risk of falls, heart and other vascular problems, and even high mortality rate.
To assess prevalence, and factors associated with hypoglycemia events among geriatric outpatients with type 2 diabetes mellitus.
The study was conducted at King Abdullah University Hospital (KAUH) at the outpatient diabetes clinic from October 1st, 2022 to August 1st, 2023. Variables such as socio-demographics, medication history, and comorbidities were obtained using electronic medical records. The prevalence of hypoglycemia was determined through patient interviews during their clinic visit. Patients were prospectively monitored for hospital admissions, emergency department visits, and mortality using electronic medical records over a three-month follow-up period. Logistic regression models were conducted to identify factors associated with hypoglycemia and hospital admissions/ emergency visits. Ethical Approval (Reference # 53/151/2022) was obtained on 19/9/2022.
Electronic medical charts of 640 patients who have type 2 diabetes mellitus and age ≥ 60 years were evaluated. The mean age ± SD was 67.19 (± 5.69) years. Hypoglycemia incidents with different severity levels were prevalent in 21.7% (n = 139) of the patients. Insulin administration was significantly associated with more hypoglycemic events compared to other antidiabetic medication. Patients with liver diseases had a significantly higher risk of hypoglycemia, with odds 7.43 times higher than patients without liver diseases. Patients with dyslipidemia also had a higher risk of hypoglycemia (odd ratio = 1.87). Regression analysis revealed that hypoglycemia and educational level were significant predictors for hospital admission and emergency department (ER) visits. Hypoglycemia was a positive predictor, meaning it increased the odds of these outcomes, while having a college degree or higher was associated with reduced odds of hospital admission and ER visits.
Current study identified a considerable prevalence of hypoglycemia among older patients with type 2 diabetes, particularly, among those with concurrent liver diseases and dyslipidemia. Furthermore, hypoglycemia was associated with an increased rate of emergency department visits and hospital admissions by 2 folds in this population.
2 型糖尿病（DM）的患病率在全球范围内一直在上升，尤其是在更容易发生与 DM 相关并发症的老年人中。与年轻的糖尿病患者相比，老年糖尿病患者发生低血糖的风险更高。老年患者发生低血糖可导致严重后果，如认知改变、跌倒风险增加、心脏和其他血管问题，甚至死亡率升高。
评估老年 2 型糖尿病门诊患者的低血糖患病率，以及与低血糖事件相关的因素。
本研究于 2022 年 10 月 1 日至 2023 年 8 月 1 日在阿卜杜拉国王大学医院（KAUH）的门诊糖尿病诊所进行。使用电子病历获取社会人口统计学、药物史和合并症等变量。通过患者在就诊期间的访谈确定低血糖的患病率。在 3 个月的随访期间，使用电子病历对患者的住院、急诊就诊和死亡进行前瞻性监测。使用逻辑回归模型确定与低血糖和住院/急诊就诊相关的因素。2022 年 9 月 19 日获得伦理批准（参考号 53/151/2022）。
评估了 640 名年龄≥60 岁且患有 2 型糖尿病的患者的电子病历。平均年龄±标准差为 67.19（±5.69）岁。不同严重程度的低血糖事件在 21.7%（n=139）的患者中普遍存在。与其他抗糖尿病药物相比，胰岛素治疗与更多的低血糖事件显著相关。患有肝脏疾病的患者发生低血糖的风险显著增加，其发生低血糖的几率是没有肝脏疾病的患者的 7.43 倍。患有血脂异常的患者也有更高的低血糖风险（比值比=1.87）。回归分析显示，低血糖和教育程度是住院和急诊就诊的显著预测因素。低血糖是一个阳性预测因子，这意味着它增加了这些结果的可能性，而具有大学学历或更高学历与降低住院和急诊就诊的可能性相关。
目前的研究发现，老年 2 型糖尿病患者中低血糖的患病率相当高，尤其是同时患有肝脏疾病和血脂异常的患者。此外，在该人群中，低血糖与急诊就诊和住院的发生率增加了 2 倍有关。
