Background: Older adults with type 2 diabetes are at increased risk of hypoglycemia. However, risk factors for hypoglycemia among older adults with diabetes in the general population are largely uncharacterized.

Methods: We included 845 participants with diabetes who attended the recent ARIC visit 6 (2016-2017). An episode of hypoglycemia was defined as the occurrence of one or more self-reported episode of severe low blood sugar reactions in the previous year (i.e., passing out, needing help to treat the reaction). We also examined alternative definitions using both broader (feeling of unacceptably low blood glucose) and stricter (two or more episodes of severely low blood glucose) self-reported criteria. We used logistic regression to evaluate risk factors for hypoglycemia.

Results: The mean age of participants was 79 years (SD: 4.3), 37% were black and 58% were female. There were 53 episodes of hypoglycemia reported. In the fully adjusted analyses, insulin therapy, lipid lowering medication, and dementia were significantly associated with hypoglycemia. Blacks were less likely to experience hypoglycemia. Results were similar with alternative definitions of hypoglycemia definitions.

Conclusions: The identified factors may aid personalization of diabetes management that reduces hypoglycemia risk among older adults, particularly those with dementia, in whom de-escalating therapy may be needed.


J.B. Echouffo Tcheugui: None. N.R. Daya: None. J.S. Pankow: None. B. Windham: None. E. Selvin: None.

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