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.

Why is blood sugar easy to be low in summer?

 Core reminder: The lower human blood sugar level in summer is firstly due to the decrease in summer sugar intake and the increase in consumption. Secondly, the human body's sensitivity to insulin increases in summer, which promotes the secretion of insulin more than in other seasons, which is also an important reason for low blood sugar in summer.

　　 The hot summer is unbearable, but this is a good time for treatment for diabetics. Because, under normal circumstances during the year, human blood sugar levels are relatively higher in winter than in spring and autumn, and summer is the season with the lowest blood sugar of the year.

    Summer consumption is the main cause of hypoglycemia

　　 Human blood sugar levels are low in summer, firstly due to the decrease in summer sugar intake and the increase in consumption. Because of the sultry summer weather, people generally lose appetite and often turn to light foods, and light foods are generally low in sugar, as if taking a low-sugar diet therapy. In addition, in the hot summer weather, although people's activities have not increased, they often sweat continuously, and the energy consumption mainly due to heat dissipation is relatively large, and the energy consumption mainly comes from the blood sugar in the body.

　　 In addition, the daylight hours in summer are longer, and the hot weather is also prone to lack of sleep, which causes the body's calorie consumption, the body's metabolism is strong, and the relative consumption of blood sugar is also increased. Therefore, people's blood sugar check is always low in summer, especially for diabetic patients.

　　 An endocrinology expert said that from a pathophysiological analysis, diabetes occurs because the insulin dysfunction in the pancreas makes insulin secretion insufficient. The main role of insulin is to promote the synthesis of glycogen from glucose and accelerate the utilization of glucose to lower blood sugar levels. Once insulin secretion is insufficient, blood sugar will rise, especially in diabetic patients. Therefore, diabetes is mainly caused by insufficient insulin secretion in the body. Relevant medical experts have found that the human body’s sensitivity to insulin increases in summer, which promotes the secretion of insulin more than in other seasons, which is also an important reason for low blood sugar in summer.

    Pay attention to blood sugar fluctuations in summer to prevent complications

　　In addition, experts suggest that diabetic patients should attach great importance to the volatility of blood sugar in summer. Studies have found that the occurrence and development of chronic complications of diabetes is not only closely related to the increase in overall blood sugar levels, but also to the fluctuation of blood sugar. The greater the blood glucose volatility, the higher the incidence of chronic complications and the worse the prognosis. Because high blood sugar fluctuations will accelerate the damage of vascular endothelial cells and lead to apoptosis, causing damage to blood vessels and causing complications; large blood sugar fluctuations will also promote abnormal sympathetic nerve excitability, thereby increasing the incidence and death of cardiovascular and cerebrovascular diseases rate.