Hypoglycemia is a common clinical problem in elderly patients with diabetes. Aging modifies the counterregulatory and symptomatic responses to
hypoglycemia.
Hypoglycemia in the elderly is not only due to tight
blood sugar control, but also due to a multitude of other factors.
Hypoglycemia often occurs with
insulin, sulfonylureas, or
meglitinide therapy. However, other causes may also contribute to
hypoglycemia, such as decreased cognition, renal impairment, or
polypharmacy. The presenting features of
hypoglycemia may be atypical and misinterpreted, resulting in
delayed treatment. Morbidity is greater in elderly patients, and the risk of progression to severe
hypoglycemia is high because of their altered symptom profile, diminished symptom intensity, and altered glycemic thresholds.
Hypoglycemia seems to be the main limiting factor in their
glycemic control. In this article we discuss strategies to prevent
hypoglycemic episodes.