Abstract 13962: Incidence of Hypoglycaemia in the Elderly With Type 2 Diabetes in Clinical Practice - Insights From the 6-Months Prospective Follow-Up of DiaRegis
Background: RCT demonstrated that intensified glucose control was associated with a higher rate of hypoglycaemia. Little is known about the incidence of hypoglycaemia in elderly patientsin clinical practice.
Methods: DiaRegis is a German prospective registry in including patients with type-2 diabetes being treated with oral mono- or dual anti-diabetic therapy. We examined differences in the incidence of hypoglycaemia in diabetic outpatients =70 years (n=1397).
Results: Elderly patients had a later diabetes onset, a better glucose control than young patients(HbA1c 7.3 vs. 7.6%; p<0.0001; fasting blood gluc. 138 vs. 146mg/dl; p<0.0001; postprandial glucose 180 vs. 189 mg/dl; p<0.0001) and more often cardiovascular diseases. Elderly patients more often received sulfonylureas (SU, 34.8 vs. 22.0%; p<0.0001), while metformin, glitazones, and DPP-4-inhibitors were less frequently used. Hypoglycaemia was a frequent complication in the elderly within 12 months prior to enrolment (12.7 vs. 9.1%; p<0.01). This led to discontinuation of SUs in elderly patients (48.0% prior vs. 18.6% after enrolment). The use of DPP-4-inhibitors increased (5.1% prior vs. 30.5% at baseline) and insulin was started in 22.6%. Overall, therapy change led to improved HbA1c in both groups (mean 6.9% in elderly and younger patients) at 6 months. In elderly patients with history of hypoglycaemia, HbA1c was slightly reduced from 7.0 to 6.9% and 29% suffered from incident hypoglycaemic events vs. 5.9% in elderly patients without history of hypoglycaemia. Incident unstable angina, autonomous and peripheral neuropathy, non-proliferative retinopathy and clinically relevant depression were more frequent in elderly patients with history of hypoglycaemia than in those without.
Conclusions: Elderly patients had a higher incidence of hypoglycaemia which may be attributed to the higher rate of sulfonylureas. This was associated with a higher risk for incident morbidity in the following 6 months.
- © 2011 by American Heart Association, Inc.