Highs & Lows: Reevaluating Hypoglycemia in Elderly Diabetes Patients
Hypoglycemia, a misunderstood diabetes complication, not only confounds the public and patients, but many healthcare providers as well. Elderly diabetes patients with hypoglycemia are especially vulnerable to this dilemma.
Mary M. Julius, RDN, CDE, clinical coordinator of Diabetes Self Management Education and Support and a research dietician and nutritionist at the Department of Veteran’s Affairs in Cleveland, Ohio, treats an 86-year-old man who has had type 1 diabetes for 50 years. His wife passed away last August. “He said to me, ‘Mary, for the past 55 years, all I’ve had to do is sit down and breakfast would be there,’” Julius says. “’I’d sit down and lunch was there. All I had to do was eat.’ He is going to bed hungry because this is a new skill for him.”
Julius’s patient is one of many in the very complex realm of hypoglycemia, and the fact that he’s in the vulnerable population of elderly people with diabetes, it only compounds the complexities. According to Julius, missing a meal is the number one cause of hypoglycemia, and elderly patients are at a higher risk of missing a meal than the general population. These patients are already frail at baseline, and older people tend not to eat as much anyway, whether they’re just not hungry or they suffer from food insecurity, but more on that later.
Hypoglycemia remains a complication of diabetes that’s not entirely understood. There still seems to be a lack of awareness among the healthcare community and the public, even among people with diabetes. For instance, hypoglycemia just isn’t as ap Continue reading