In Japan, The prevalence of type 2 diabetes mellitus (T2DM) is increasing, especially in the elderly population. Many of these patients have co-morbidities like renal insufficiency and personalized blood sugar goals, increasing the risk of hypoglycemia. This study was conducted to examine the associations of patients characteristics such as HbA1c level, BMI and use of glucose level-lowering medication with hypoglycemia-related hospitalizations.
This study was cross sectional study conducted over 6 years January 2014 and March 2019. We recruited 9,798 patients with elderly patients over 65 years with T2DM. To assess the odds ratio (OR) of hypoglycemia-related hospitalizations, we constructed a logistic regression analysis, having adjusting for age, gender, BMI, eGFR, baseline HbA1c levels, use of hypoglycemic agents.
Hypoglycemia was documented in 124 (1.27%) patients. In multivariate logistic regression analysis, age≧75years and gender were not significantly. DPP-4I (OR: 0.52, 95%CI: 0.28-0.96) showed lower odds ratio. BMI≦25kg/m2 (OR: 2.94, 95%CI: 1.26-6.86), baseline HbA1c<6.0% (OR: 4.43, 95%CI: 2.25-8.73), eGFR 15-≦30 mL/min(OR: 2.54, 95%CI: 1.05-6.10), <15mL/min(OR: 3.01, 95%CI: 1.26-7.16), Insulin (OR: 2.05, 95%CI: 1.22-3.43) showed higher odds ratio.
In this study of elderly patients with T2DM, the risk of hospitalization for hypoglycemia appeared to be highest among patients with too low Hba1c and BMI, decreased renal function, and sulfonylurea and/or insulin use. On the other hand, DPP-4I have been shown to reduce the risk of hospitalization for hypoglycemia. By leveraging the results of this study, at-risk elderly patients can benefit from individualized treatment plans to reduce the risk of hypoglycemia.
T. Horii: None. K. Atsuda: None.