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The social burden of hypoglycemia in the elderly

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Abstract

Aims

The study aimed to evaluate the frequency of episodes of symptomatic hypoglycemia (SH) in elderly patients with type 2 diabetes and their impact on quality of life.

Methods

The study was conducted in 12 Italian regions. Participants filled in a questionnaire collecting data on socio-demographic and clinical characteristics and episodes of SH occurred in the last 4 weeks. The questionnaire included validated scales measuring fear of hypoglycemia (FHQ), psychological well-being (WHO-5), and diabetes-related distress (PAID-5).

Results

Overall, 1,323 participants were involved (mean age 70.0 ± 8.7, 47.6 % male, disease duration 15.6 ± 11.7, 63.2 % treated with oral agents, 16.9 % with insulin alone, 14.4 % with insulin plus oral agents), of whom 44.6 % reported 1–3 episodes of SH and 23.8 % reported more than 3 episodes. Patients who reported SH had significantly higher levels of fear of hypoglycemia, lower psychological well-being, and higher diabetes-related distress (p < 0.0001 for all the scales). At multivariate analysis, the experience of more than 3 episodes of hypoglycemia was associated with a 13-fold higher risk of high fear of hypoglycemia (aOR = 13.3; CI 95 % 8.4–21.0), an almost 60-fold higher risk of high diabetes-related distress (PAID-5 score ≥40) (aOR = 59.1; CI 95 % 29.2–119.8), and a higher risk of low psychological well-being (WHO-5 <50) (aOR = 1.5; CI 95 % 0.9–2.4).

Conclusions

The occurrence of symptoms of hypoglycemia is very common among older adults with diabetes and their presence is associated with an extremely negative impact on quality of life. Minimizing the risk of hypoglycemia represents a high priority in the diabetes treatment of elderly people.

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Conflict of interest

The authors declare they have no conflict of interest.

Ethical standard

The study was reviewed by appropriate ethics committee and performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki.

Human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Declaration of Helsinki of 1975, as revised in 2008.

Informed consent

Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Italian Barometer Diabetes Observatory, Università Tor Vergata, Rome, Italy

    Antonio Nicolucci, Francesco Dotta, Simona Frontoni, Salvatore Caputo & Renato Lauro

  2. Department of Clinical Pharmacology and Epidemiology, Fondazione Mario Negri Sud, Via Nazionale 8/A, 66030, S. Maria Imbaro, CH, Italy

    Antonio Nicolucci, Basilio Pintaudi & Maria Chiara Rossi

  3. FederAnziani, Rome, Italy

    Roberto Messina

  4. Diabetes Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy

    Francesco Dotta

  5. Fondazione Umberto Di Mario ONLUS, Toscana Life Sciences, Siena, Italy

    Francesco Dotta

  6. Dipartimento di Medicina dei Sistemi, Università degli Studi di Roma “Tor Vergata”, Rome, Italy

    Simona Frontoni

  7. Servizio di Diabetologia, Policlinico Gemelli, Università Cattolica, Rome, Italy

    Salvatore Caputo

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  1. Antonio Nicolucci
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Correspondence to Antonio Nicolucci.

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Nicolucci, A., Pintaudi, B., Rossi, M.C. et al. The social burden of hypoglycemia in the elderly. Acta Diabetol 52, 677–685 (2015). https://doi.org/10.1007/s00592-015-0717-0

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  • DOI: https://doi.org/10.1007/s00592-015-0717-0

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