Hypoglycemia as a Predictor of Mortality in Hospitalized Elderly Patients

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Abstract
HYPOGLYCEMIA IS a well-recognized complication in ambulatory patients with diabetes mellitus (DM).1-4 Despite the high prevalence of hypoglycemia in ambulatory patients with diabetes, severe symptoms such as loss of consciousness or death are rare.4 Hypoglycemia during hospitalization, which has been evaluated by a limited number of studies, occurs in patients with and without diabetes and has been associated with in-hospital increased mortality.5-7 The clinical significance of hypoglycemia in the older hospitalized population was addressed by a recent study that included 60 patients without diabetes and found hypoglycemia to be an independent risk factor for in-hospital mortality.7 Elderly people are more prone to complications including hypoglycemia during hospitalization owing to frailty, undernourishment, multiple-organ failure, and polypharmacy.8,9 Hypoglycemia may also go unrecognized in the elderly population because of restricted communication, cognitive impairment, and possibly fewer adrenergic symptoms.10