Hypoglycemia in Older People - A Less Well Recognised Risk Factor for Frailty

Recently one of the Blogger Babies was diagnosed with Hypoglycemia and condition usually attributed to Diabetes. Blogger Baby isn’t a diabetic but he suffers from hypoglycemia and Ketonemia.

Having listen to the Doctors and discussing the conditions with experts in their field of medicine I realised that Hypoglycemia and Ketonemia and not solely related to diabetes or the young.  It is in fact a condition that is largely unreported in the Elderly.

So, I did what anyone would do I looked it up on the web and to my surprise I found very little relating to the Elderly and Hypoglycemia.

Hypoglycemia in Nondiabetic Elderly Patients is so unknown awareness needs to be raised.

In older adults’ low blood sugar unawareness and blood sugar variability are associated with an increased risk of severe hypoglycemia.

It is a major problem in older adults.

The symptoms of hypoglycemia include:

·         shakiness,

·         sweating,

·         fast heartbeat,

·         nervousness,

·         confusion

·         and

·         dizziness. This is particularly dangerous in older adults because it could result in falls. This in turn could lead to fractures and hospitalization. However, little information is available about the risk factors associated with hypoglycemia in older adults. 

Causes of Hypoglcemia are also a medical unknown especially in the Elderly, however figures have shown that patients had a high prevalence of

·         Liver disease

·         Renal insufficiency

·         Malignancy

·         Congestive Heart Failure

·         Sepsis

·         Dementia relation conditions

Hypoglycemia commonly occurs in patients with diabetes mellitus (DM) and may negatively influence cognitive performance. Cognitive impairment in turn can compromise DM management and lead to hypoglycemia.

So, what are the signs and symptoms of Hypoglecemia?

Hypoglycemia occurs when blood glucose levels fall below 4 mmol/L (72mg/dL).

Whilst many of us think of diabetes as being a problem of high blood sugar levels, the medication some people can also cause their sugar levels to go too low and this can become dangerous.

The main symptoms associated with hypoglycemia are:

·         Sweating

·         Fatigue

·         Feeling dizzy

·         Anxiety

·         Shakiness

·         Nervousness

·         Nausea, vomiting or abdominal discomfort

Symptoms of hypoglycemia can also include:

·         Being pale

·         Feeling weak

·         Feeling hungry

·         A higher heart rate than usual

·         Blurred vision

·         Confusion

·         Convulsions

·         Loss of consciousness

·         And in extreme cases, coma

What are the causes of hypoglycemia?

Whilst medication is the main factor involved in hypoglycemia within people with diabetes, a number of other factors can increase the risk of hypos occurring.

Factors linked to a greater risk of hypos include:

·         Too high a dose of medication (insulin or hypo causing tablets)

·         Delayed meals

·         Exercise

·         Alcohol

You can take steps to minimise the risk of these factors causing hypos.

In adults, moderately severe hypoglycemia can resemble mania, mental illness, drug intoxication, or drunkenness. In the elderly, hypoglycemia can produce focal stroke- -like effects or a hard-to-define malaise.

The symptoms of a single person may be similar from episode to episode, but are not necessarily so and may be influenced by the speed at which glucose levels are dropping, as well as previous incidents.

Other causes of hypoglycemia include kidney failure, certain tumors, liver disease, hypothyroidism, starvation, inborn errors of metabolism, severe infections, reactive hypoglycemia, and a number of drugs including alcohol.

We can only advise that if you are concerned about the risk of hypoglycaemia, talk to your doctor about ways to avoid low blood sugar levels from occurring.