Severe hypoglycaemia ups risk of adverse outcomes in older patients

Severe hypoglycaemia is a risk factor for hospitalization and mortality among older patients with diabetes, a study reports. The event may also serve as a marker of future cardiovascular (CV) events among those with pre-existing heart disease and obesity.

Researchers looked at 399 emergency department (ED) admissions for severe hypoglycaemia in adults with diabetes and compared the clinical differences between older (aged ≥65 years) and younger individuals (aged 18–64 years). They applied logistic regression to explore predictors of hospitalization (due to CV or other reasons) following ED admission and 1 year later, as well as of 1-year all-cause mortality.

The analysis included 302 patients (median age 75 years, 50.3 percent female, 93.4 percent White, HbA1c level 7.6 percent). Hospitalization following ED admission was documented in 16.2 percent of the population, and kidney failure was the only factor that emerged as significantly predictive of non-CV hospitalization (odds ratio [OR], 0.50, 95 percent confidence interval [CI], 1.29–5.03).

Meanwhile, 24.5 percent of patients were hospitalized 1 year after ED admission. CV-specific hospitalization at 1 year was significantly associated with obesity (OR, 3.17, 95 percent CI, 1.20–8.12) and pre-existing heart disease (OR, 3.20, 95 percent 1.20–9.39).

Finally, 1-year all-cause mortality occurred in 14.9 percent of patients. Risk factors for this outcome were older age (OR, 1.12, 95 percent CI, 1.07–1.18) and pre-existing heart disease (OR, 2.63, 95 percent CI, 1.19–6.14).

The findings indicate a need for a less stringent glycaemic control and the adoption of therapeutic strategies aimed at preventing hypoglycaemia, especially for older patients with declining health status.