Frequency of Hypoglycemia in Elderly Patients on Oral Hypoglycemics Vs Insulin Therapy Presenting to the Accident and Emergency Department of a Tertiary Care Hospital
DOI:
https://doi.org/10.51253/pafmj.v76iSUPPL-7.13080Keywords:
Elderly, Hypoglycemia, Insulin Therapy, Oral Hypoglycemics, Risk Factors, Type 2 Diabetes MellitusAbstract
Objective: To assess the frequency of hypoglycemia in elderly patients on oral hypoglycemics vs insulin therapy presenting to A&E, and to assess associated risk factors.
Study design: Comparative Cross-sectional study.
Place and Duration of Study: Accident and Emergency Department, Combined Military Hospital (CMH), Rawalpindi, Pakistan, from Jul to Dec 2024.
Methodology: The data were collected from 155 elderly patients (≥60 years) with T2DM who presented to the A&E department with symptoms suggestive of hypoglycemia or documented hypoglycemia (BSR<70mg/dl). Patients were categorized into oral hypoglycemic agents (n= 78, 50.3%) and insulin therapy (n= 77, 49.7%). Data was analyzed using SPSS 25 with chi-square test and logistic regression applied to determine associations.
Results: The mean age of the patients was 68.5±5.7 years. Severe hypoglycemia was significantly more frequent in insulin users (39%) compared to oral hypoglycemic users (15.4%, p=0.004). Sulfonylureas were responsible for 41% of hypoglycemia cases in oral drug users. Renal impairment (OR= 2.2, p= 0.029) and medication overdose (OR= 2.2, p=0.029) were identified as independent risk factors for hypoglycemia. Key risk factors included longer diabetes duration (>10 years, p=0.012), poor medication adherence (OR = 2.2, p=0.008), and low BMI (p= 0.019).
Conclusion: Insulin therapy is associated with a higher frequency of severe hypoglycemia in elderly patients compared to oral hypoglycemics. Renal impairment, missed meals, and medication errors significantly contribute to hypoglycemia risk. Regular monitoring, individualized treatment strategies, and patient education are essential to minimize hypoglycemia-related emergency visits in elderly diabetic patients. Future research with larger, ,,
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