Older adults living with type 1 diabetes
Recent data presented at the Endocrine Society Annual meeting held in New Orleans reports that older adults (aged over 60 years) living with type 1 diabetes (T1D) spend more than an hour daily with blood glucose values in the hypoglycemic range (blood glucose levels lower than 4.0 mmol/L).
Hypoglycemia at an older age
The team working on this study observed a scarcity in terms of research done on older adults with T1D which makes it difficult to understand the condition in this specific age group and consequently improve its management. Thus, they studied about 200 adults with T1D aged 60 and older by having them use a continuous glucose monitor (CGM) for up to 21 days. The data collected allowed them to prove that indeed the older T1D population spends on average 72 minutes per day with blood sugar levels under 4.0mmol/L and 24 minutes with blood sugar levels under 3.0mmol/L. They then plan to evaluate if the use of CGM can help better detect, and thus reduce, hypoglycemia in this age group.
Recurrent low blood sugar could increase the risk of severe hypoglycemia (need of a third party assistance to treat an episode or loss of consciousness). According to the American Diabetes Association older adults are at high risk for severe hypoglycemia and hypoglycemia unawareness (the absence or reduced awareness of hypoglycemia symptoms). Which could be due to longer diabetes duration in aging people living with type 1 diabetes. Long duration of diabetes can impact body’s abilities to fight against hypoglycemia by reducing: 1) the appearance of hypoglycemia symptoms and 2) the secretion of necessary fighting hormones such as glucagon and epinephrine.
Hypoglycemia can have serious consequences including reduced quality of life and increased falls and is a well known factor against achieving glycemic goals. This study adds to current evidence that hypoglycemia remains too frequent for patients living with T1D, including patients over 60 years of age in spite of their large experience with T1D management.
Hypoglycemia in older population, as well as across ages, is a very important daily challenge for persons living with type 1 diabetes, hence the decision to set it as a priority for the BETTER project. Tell us about your experience with T1D and hypoglycemia by completing our questionnaire.
1- Carlson, A. L. (2019). CGM shows hypoglycemia common in older adults with type 1 diabetes. Retrieved from https://www.healio.com/endocrinology/diabetes/news/online/%7Bb73656c8-de46-4f36-9e3f-9d832ec15642%7D/cgm-shows-hypoglycemia-common-in-older-adults-with-type-1-diabetes
2- Dhaliwal, R., & Weinstock, R. (2014). Management of type 1 diabetes in older adults. Diabetes Spectrum : A Publication of the American Diabetes Association,27(1), 9-20. doi:10.2337/diaspect.27.1.9