Background: Few studies have examined the psychosocial and behavioral determinants of hypoglycemia in older adults with type 2 diabetes.

Methods: We conducted a cross-sectional analysis of the self-reported causes of hypoglycemia among participants in the Atherosclerosis Risk in Communities (ARIC) study (visit 6, 2016-2017) with diagnosed diabetes who self-reported experiencing at least one episode of hypoglycemia in the past 12 months. Information on hypoglycemia history and potential causes of low glucose were obtained through in-person interviews. Participants could select multiple hypoglycemia causes.

Results: Among the 818 ARIC participants with diabetes (mean age 79), 362 (44%) self-reported experiencing hypoglycemia in the past year. Overall, 68% of these individuals attributed experiencing low glucose to improper food timing (e.g., skipping a meal); 32% to eating the wrong type of food; 19% to increased physical activity; and 12% to wrong medication dosage. Eight to 20% also reported that mood change or illness contributed to prior hypoglycemic events (Figure).

Conclusion: Timing of meals in older adults with diabetes may be an important component in diabetic education to reduce hypoglycemia risk. Further research is needed to determine how emotions and illness relate to hypoglycemia.


M. Fang: None. J.B. Echouffo Tcheugui: None. B. Windham: None. E. Selvin: None.


National Heart, Lung, and Blood Institute (T32HL007024 to M.F.); National Institute of Diabetes and Digestive and Kidney Diseases (K24DK106414 to E.S.)

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