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. 2014:2014:906103.
doi: 10.1155/2014/906103. Epub 2014 Feb 13.

Hypoglycemia is independently associated with multidimensional impairment in elderly diabetic patients

A Pilotto  1 , M Noale  2 , S Maggi  2 , F Addante  3 , A Tiengo  4 , P Cavallo Perin  5 , G Rengo  6 , G Crepaldi  2
Affiliations

Hypoglycemia is independently associated with multidimensional impairment in elderly diabetic patients

A Pilotto et al. Biomed Res Int. 2014.

Abstract

Aim: To identify the characteristics associated with multidimensional impairment, evaluated through the Multidimensional Prognostic Index (MPI), a validated predictive tool for mortality derived from a standardized Comprehensive Geriatric Assessment (CGA), in a cohort of elderly diabetic patients treated with oral hypoglycemic drugs.

Methods and results: The study population consisted of 1342 diabetic patients consecutively enrolled in 57 diabetes centers distributed throughout Italy, within the Metabolic Study. Inclusion criteria were diagnosis of type 2 diabetes mellitus (DM), 65 years old or over, and treatment with oral antidiabetic medications. Data concerning DM duration, medications for DM taken during the 3-month period before inclusion in the study, number of hypoglycemic events, and complications of DM were collected. Multidimensional impairment was assessed using the MPI evaluating functional, cognitive, and nutritional status; risk of pressure sores; comorbidity; number of drugs taken; and cohabitation status. The mean age of participants was 73.3 ± 5.5 years, and the mean MPI score was 0.22 ± 0.13. Multivariate analysis showed that advanced age, female gender, hypoglycemic events, and hospitalization for glycemic decompensation were independently associated with a worse MPI score.

Conclusion: Stratification of elderly diabetic patients using the MPI might help to identify those patients at highest risk who need better-tailored treatment.

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