Hypoglycaemia – low blood glucose – is more common in older people and can lead to severe physical and cognitive impairment if left untreated.
Dr Ahmed El-Laboudi, a consultant endocrinologist and diabetologist from Imperial College London Diabetes Centre (ICLDC), explains that diabetes education and the latest technology can play a large part in managing and preventing dangerous episodes.
He says, “Several factors, including the increased duration of diabetes and age-related physiological changes, make the elderly more prone to hypoglycaemia. Patients can experience a multitude of symptoms including excessive sweating, dizziness, palpitations, nausea, visual disturbance and confusion when they are having an episode.”
In elderly people, hypos can lead to serious consequences. For example, being unable to compose themselves during an attack can result in falls and fractures. It also increases the risk of arrhythmias, and studies have also shown a link to dementia. Alongside education, new technologies – such as continuous glucose monitoring (CGM) – can help manage blood glucose levels, alerting them when they are at risk and significantly improving their quality of life.
Dr El-Laboudi explains, “CGM technology can be very liberating for people with diabetes who have frequent episodes of hypoglycaemia, not only because they help identify unrecognised hypoglycaemic episodes, but also because they are equipped with alarms that sound when hypoglycaemia is reached or predicted. This is particularly crucial for patients who may have an episode while asleep, or if they do not experience classic warning symptoms of hypoglycaemia.
“CGM devices are valuable tools for physicians, too, because they are constantly relaying data points, such as when a patient is experiencing high or low blood sugar, and what is happening when they are asleep, when they eat and when they exercise. This insight can help us adjust therapy in a way that improves the patient’s control over their glucose levels without raising the risk of hypoglycaemia. Furthermore, CGM technology plays an essential role in an effective telemedicine ecosystem and has shown its value during COVID-19 related lockdown, since CGM users can share their data remotely with their healthcare team.”
Trade off?
ICLDC’s multidisciplinary team, which includes diabetologists, endocrinologists, diabetes educators, dietitians and psychologists, provides ongoing support and education to help people live well with diabetes. The centre is seeing an increase in patients in the UAE adopt glucose monitoring devices to manage their condition. The centre has more than 4,000 patients who use CGMs.
Using an example of a 68-year-old, Dr El-Laboudi states that many elderly patients believe hypoglycaemia is either something they must live with or try to avoid by keeping their glucose levels high, saying: “This patient believed that having episodes of low blood sugar was a trade-off that came with avoiding high blood sugar levels. She did not have many classical warming symptoms either and did not realise the risk of frequent exposure to hypoglycaemia. But armed with the knowledge from our educators and data that she has been receiving from her device, she has been able to deal with them better and reduce future episodes.”
As reported by MenaFM.
