Hypoglycemia in Older Adults with Type 1 Diabetes

Stephanie N. DuBose, Ruth S. Weinstock, Roy W. Beck, Anne L. Peters, Grazia Aleppo, Richard M. Bergenstal, Henry Rodriguez, Joseph F. Largay, Elaine M. Massaro, Irl B. Hirsch

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Abstract

Background: Hypoglycemia is a major concern in older adults with type 1 diabetes (T1D) and there is limited knowledge in this population. We examined data from 199 adults, ≥60 years of age, who participated in a T1D Exchange study assessing factors associated with severe hypoglycemia (SH) in older adults with T1D: 100 with SH in the prior year and 99 with no SH in prior 3 years (mean age 68; mean diabetes duration 40 years; 47% female; 92% non-Hispanic white). Hypoglycemia was assessed with up to 14 days of blinded continuous glucose monitoring (CGM). Linear regression models were performed to assess the association between biochemical hypoglycemia [defined as percentage of time below specific cutoffs (<70/60/50 mg/dL)] and various factors. Results: Overall, participants had CGM values <70 mg/dL for a median of 91 min per day. On 53% of days, glucose levels continuously were <70 mg/dL for ≥20 min. Hypoglycemia was found to be strongly associated with glucose variability (r = 0.76; P < 0.001). Time spent in hypoglycemia was greater in those who were younger (P = 0.004), had shorter diabetes duration (P = 0.008), lower HbA1c (P < 0.001), and undetectable C-peptide (P = 0.001), but did not differ by insulin method, education level, number of blood glucose checks per day, cognition, activities of daily living, or fear of hypoglycemia. Innovation: This study adds valuable data on the frequency of hypoglycemia in older adults with T1D. Conclusion: Future studies need to focus on how to prevent hypoglycemia in this vulnerable population of older adults with long-standing T1D.

Original languageEnglish
Pages (from-to)765-771
Number of pages7
JournalDiabetes Technology and Therapeutics
Volume18
Issue number12
DOIs
StatePublished - Dec 1 2016

Fingerprint

Hypoglycemia
Glucose
Linear Models
C-Peptide
Vulnerable Populations
Activities of Daily Living
Cognition
Fear
Blood Glucose
Insulin
Education

Keywords

  • Diabetes management
  • Hypoglycemia
  • Older adults
  • Type 1 diabetes

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Medical Laboratory Technology

Cite this

DuBose, S. N., Weinstock, R. S., Beck, R. W., Peters, A. L., Aleppo, G., Bergenstal, R. M., ... Hirsch, I. B. (2016). Hypoglycemia in Older Adults with Type 1 Diabetes. Diabetes Technology and Therapeutics, 18(12), 765-771. DOI: 10.1089/dia.2016.0268

Hypoglycemia in Older Adults with Type 1 Diabetes. / DuBose, Stephanie N.; Weinstock, Ruth S.; Beck, Roy W.; Peters, Anne L.; Aleppo, Grazia; Bergenstal, Richard M.; Rodriguez, Henry; Largay, Joseph F.; Massaro, Elaine M.; Hirsch, Irl B.

In: Diabetes Technology and Therapeutics, Vol. 18, No. 12, 01.12.2016, p. 765-771.

Research output: Contribution to journalArticle

DuBose, SN, Weinstock, RS, Beck, RW, Peters, AL, Aleppo, G, Bergenstal, RM, Rodriguez, H, Largay, JF, Massaro, EM & Hirsch, IB 2016, 'Hypoglycemia in Older Adults with Type 1 Diabetes' Diabetes Technology and Therapeutics, vol 18, no. 12, pp. 765-771. DOI: 10.1089/dia.2016.0268
DuBose SN, Weinstock RS, Beck RW, Peters AL, Aleppo G, Bergenstal RM et al. Hypoglycemia in Older Adults with Type 1 Diabetes. Diabetes Technology and Therapeutics. 2016 Dec 1;18(12):765-771. Available from, DOI: 10.1089/dia.2016.0268

DuBose, Stephanie N.; Weinstock, Ruth S.; Beck, Roy W.; Peters, Anne L.; Aleppo, Grazia; Bergenstal, Richard M.; Rodriguez, Henry; Largay, Joseph F.; Massaro, Elaine M.; Hirsch, Irl B. / Hypoglycemia in Older Adults with Type 1 Diabetes.

In: Diabetes Technology and Therapeutics, Vol. 18, No. 12, 01.12.2016, p. 765-771.

Research output: Contribution to journalArticle

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