Older adults with type 2 diabetes have better blood sugar control during hospitalization than younger people

The study showed that older patients in their hospital stay had lower HbA1c and blood glucose levels and a higher percentage of time in range than younger patients. Also, the researchers observed no difference in hypoglycemia between the groups. Furthermore, frailty was linked with a longer duration of hypoglycemia in hospitalized patients.

Hospitalized older adults with diabetes are generally managed similarly to younger adults. However, the degree of frailty affecting glucose control among hospitalized patients is unknown. To fill this knowledge gap, T. Idrees from Emory University School of Medicine in Atlanta, GA, United States, and colleagues examined glycemic parameters derived from CGM (continuous glucose monitoring) in elderly with frailty and type 2 diabetes hospitalized in non-acute settings.

For this purpose, the researchers pooled data from 3 prospective studies using CGM, including 166 patients wearing Dexcom G6 CGM and 97 patients wearing Libre CGM sensors. A comparison was drawn between glycemic parameters (time below range (TBR) <70; time in range (TIR) 70–180) by CGM between 103 older adults ≥60 years and 168 younger adults <60 years. Frailty was evaluated using validated laboratory and vital signs frailty index FI-LAB (n = 85), and the researchers studied its effect on hypoglycemia risk.

The study's key findings of the study were as follows:

· Older adults had remarkably lower admission HbA1c (8.76% ± 1.82 versus 10.25% ± 2.29), blood glucose (203.89 ± 88.65 versus 247.86 ± 124.17 mg/dl), mean daily BG (173.9 ± 41.3 versus 183.6 ± 45.0 mg/dl) and greater percent TIR 70–180 mg/dl (59.0 ± 25.6% versus 51.0 ± 26.1%) during the hospital stay as compared to younger adults.

· The researchers observed no difference in hypoglycemia occurrence between older and younger adults.

· Higher FI-LAB score was linked with higher % CGM < 70 mg/dl and % CGM < 54 mg/dl.

"Compared to younger adults, older adults with type 2 diabetes have better glycemic control before admission and during a hospital stay," the researchers wrote. "Frailty is associated with the longer presence of hypoglycemia in non-acute hospital settings."

Reference:

Idrees T, Zabala ZE, Moreno EM, Gerges A, Urrutia MA, Ruiz JG, Vaughan C, Vellanki P, Pasquel FJ, Peng L, Umpierrez GE. The effects of aging and frailty on inpatient glycemic control by continuous glucose monitoring in patients with type 2 diabetes. Diabetes Res Clin Pract. 2023 Mar 5;198:110603. doi: 10.1016/j.diabres.2023.110603. Epub ahead of print. PMID: 36871877.