HbA1c Concentration of Elderly Diabetic Patients with the Hypoglycemic Shock who were Admitted via Emergency Room

Park, Jin Cheol; Yoo, Hyung Joon; Yim, Hae Seang; Kim, Yong Tae; Jin, Do Kyun; Kim, Hyun Kyu; Kim, Doo Man; Yoo, Jae Myung; Ihm, Sung Hee; Choi, Moon Gi; Park, Sung Woo

Abstract

BACKGROUND: Mild degree of hypoglycemia is not unusual during drug therapy in elderly diabetic patients. However it is very difficult that the precise incidence of hypoglycemia is measured in elderly patients because the decreased cognitive function and autonomic dysfunction contribute to atypical hypoglycemic symptoms and signs. Therefore, most cases of elderly diabetic patients with hypoglycemia are discovered in comatose mental state. We did this study to evaluate the clinical charaeteristics of elderly diabetic patients with the hypoglycemic shock who were admitted via emergency room.
METHODS
We analyzed the precipitating factors, mental status, and blood chemistries of the adult group(n=22, age 51+3.6 year, BMI-19 kg/m2) and elderly group(n=37, age=72+4.3 year, BMI=23 kg/m) that were classified by the point of 65 years old who were admitted via emergency room in state of the hypoglycemic shock.
RESULTS
1) In the precipitating factor of hypoglycemia, irregular oral intake was found in 64%(14/22) of the adult group and 64%(23/37) of the elderly group, and drug overdose was found in 27 %(1.6/22) of the adult group and 24%(9/37) of the elderly group. But there, was no significant difference between the adult and elderly group. 2) Those who arrived at the emerency room in comatose mental status were found in 45.5 % of adult group and 54.1 % of elderly group, that was no difference stastically. 3) HbA 1c was 5.8 +- 0.27% in elderly group and 8.0 +- 0.63% in the adult group who arrived at the emergency room, which was stastically significant difference between two groups.
CONCLUSION
We concluded that lower HbA 1c in the elderly group than adult group who arrived at the emergency room suggest there was probability of unrecognized mild hypoglycemia before the onset of hypoglycemic shock.