Assessing hypoglycemia frequency using flash glucose monitoring in older Japanese patients with type 2 diabetes receiving oral hypoglycemic agents.

Abstract

AIM:

It is important to consider hypoglycemia for glycemic control in elderly patients with type 2 diabetes. Continuous blood glucose monitoring system is an effective method to investigate blood glucose fluctuation. This study examined hypoglycemia frequency using continuous blood glucose monitoring system in older patients with type 2 diabetes.

METHODS:

A total of 70 patients with type 2 diabetes aged >65 years, receiving oral treatment only and having a glycated hemoglobin (HbA1c) level of <8% were enrolled. Flash glucose monitoring system was used for the device. Patients were classified into three groups according to the type of medicine administered, in addition to other oral hypoglycemics, and were compared: (i) those taking sulfonylureas (SU); (ii) those taking glinides; and (iii) those who did not take either SU or glinides.

RESULTS:

There was a significant positive correlation between the coefficient of variation and hypoglycemic frequency in all the patients, and a significant negative correlation between HbA1c and hypoglycemia in those receiving SU. When hypoglycemia was defined as glucose levels <54 mg/dL and <70 mg/dL, the cut-off HbA1c values for developing hypoglycemia were 6.3% and 6.7%, sensitivity was 75.0% and 76.2%, and specificity was 90.9% and 77.6%, respectively.

CONCLUSIONS:

In older patients with type 2 diabetes receiving SU, hypoglycemic frequency increases with decreases in HbA1c level. In particular, in patients with HbA1c levels of <6.3% receiving SU, it is necessary to consider medication modification. Geriatr Gerontol Int 2019; 19: 1030-1035.

• Authors: Hironori Abe, Junpei Shikuma, Hirotsugu Suwanai, Koji Sano, Takako Okumura, Kenshi Kan, Tomono Takahashi, Takashi Miwa, Ryo Suzuki, Masato Odawara
• Journal: Geriatrics & gerontology international (Geriatr Gerontol Int) Vol. 19 Issue 10 Pg. 1030-1035 (Oct 2019) ISSN: 1447-0594 [Electronic] Japan
• PMID: 31486247 (Publication Type: Journal Article, Observational Study)
• Copyright: © 2019 The Authors Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

Chemical References

• Blood Glucose
• Glycated Hemoglobin A
• Hypoglycemic Agents
• Insulin
• Sulfonylurea Compounds

Topics

• Administration, Oral
• Aged
• Blood Glucose (metabolism)
• Blood Glucose Self-Monitoring
• Diabetes Mellitus, Type 2 (blood, drug therapy)
• Female
• Glycated Hemoglobin (chemistry, metabolism)
• Humans
• Hypoglycemia (blood, diagnosis)
• Hypoglycemic Agents (administration & dosage, therapeutic use)
• Insulin (metabolism)
• Japan
• Male
• Prospective Studies
• Sulfonylurea Compounds (administration & dosage, therapeutic use)