High risk of hypoglycemia in elderly people with diabetes

 Hypoglycemia is one of the serious complications of diabetes, and the risk of hypoglycemia in elderly diabetic patients is higher than that of younger patients, and it is more harmful, so we should pay more attention to it.

　　 Hypoglycemia is related to the occurrence of adverse events such as macrovascular and microvascular complications, falls or fractures, and may even lead to death. In addition, some scholars believe that hypoglycemia is also related to the increased risk of cognitive dysfunction, which shows that the harm is huge. The function of body organs and tissues of elderly diabetic patients is weakened, and the metabolic decomposition and excretion of hypoglycemic drugs are reduced, which can lead to drug accumulation and increase the risk of hypoglycemia. In addition, as we age, the secretion of blood glucose-promoting hormones (such as glucagon, epinephrine, etc.) that are used to resist hypoglycemia in the body decreases, which is also one of the factors that cause hypoglycemia. Retrospective studies have confirmed that the incidence of hypoglycemia in diabetic patients increases with age, which means that compared with younger groups, elderly diabetic patients have a higher risk of hypoglycemia and should be paid more attention.

In addition, the symptoms of hypoglycemia in elderly diabetic patients are often atypical, usually manifested as sympathetic nervous system excitement or neurohypoglycemia. The former manifests as palpitations, pale complexion, weak hands and feet, trembling hands, and mental tension. The latter manifests itself as symptoms such as palpitations, pale complexion, weak hands and feet, trembling hands, and nervousness. Neurological disorders, mental disorders, abnormal behaviors, inattention, and confusion. In severe cases, dizziness, headaches, and hearing loss may occur, and in more severe cases, it may lead to coma. Special attention should be paid to patients with such manifestations. The prevention of hypoglycemia is the key point. To reduce the risk of hypoglycemia in elderly people with diabetes, you can start from the following five aspects.

　　1 Choose low-risk hypoglycemic drugs

　　 Elderly diabetic patients choose hypoglycemic drugs, which should give consideration to both efficacy and safety. The first application needs to start with a small dose, closely observe blood glucose changes and adverse reactions, and gradually increase the dose.

　　2 Some drugs will increase the risk of hypoglycemia, should be noted

Elderly diabetic patients are often accompanied by multiple diseases and may use multiple drugs. 

　　3 The setting of blood glucose goals needs to be individualized, do not blindly pursue low goals

　　 The goal of blood glucose management should follow the principle of individualization. Pursuing a low level that is inconsistent with one's own condition will inevitably lead to an increased risk of hypoglycemia, which is bad for health. The first thing to mention is the risk of hypoglycemia.

　　4 Eat a reasonable diet and eat on time

　　 Low dietary intake and failure to eat meals on time are important causes of hypoglycemia in elderly diabetic patients. Therefore, it is very necessary to develop good eating habits.

It is recommended to do the following three points: 1) Eat a regular diet to ensure the daily calorie supply; 2) Arrange a reasonable diet, appropriately limit carbohydrate foods, and its energy supply should account for 50%-60%, including 10% For fruits and vegetables, eat more foods with high energy density, high dietary fiber, and low glycemic index; 3) The recommended meal mode is to eat less and more meals, eat slowly, first with soup and then staple food.

　　 In addition, because alcohol stimulates insulin secretion, elderly patients who have a drinking habit should not drink excessively or on an empty stomach.

　　5 Exercise reasonably, not excessive

　　Excessive exercise and wrong choice of exercise time are also important factors leading to increased risk of hypoglycemia. The exercise management of elderly patients needs to be individualized. People with normal physical ability, the frail elderly, the physically handicapped, and the mentally handicapped respectively choose the whole body or limb exercises that can be carried out and are easy to adhere to.

　　 In order to relieve postprandial hyperglycemia and reduce the risk of hypoglycemia, it is recommended to exercise moderately within 1-2 hours after a meal, exercise duration should not exceed 30 minutes, and exercise 4-5 times a week. Elderly patients should routinely check their footwear and feet before and after exercise, and should avoid exercising in high temperature and high humidity environments. Special attention should be paid to avoid strenuous activities during the period after insulin injection to before meals.