Background Little is known about the prevalence of hypoglycaemia in older people with diabetes. However, the HbA1c goal is ≥8% for institutionalised patients with treatments that can cause hypoglycaemia. Purpose We aimed to assess the prevalence of hypoglycaemia with continuous glucose monitoring and to evaluate the link with HbA1C in older institutionalised patients with diabetes taking potentially hypoglycaemia-inducing drugs. Design Prospective, multicentre study carried out in six geriatric care centres in the Côte d’Or region of France between January 2019 and July 2020. Settings, subjects and methods A FreeStyle Libre Pro® (FSLP) was worn for up to 14 days in blinded mode in 42 patients taking at least one potentially hypoglycaemia-inducing antidiabetic drug. Results Two hundred and forty-two hypoglycaemic events were detected in 79% (n = 33) of patients wearing the FSLP. One or more hypoglycaemic event was detected in 100% of patients with HbA1C < 7% and in 79% of patients with HbA1C ≥ 8% (P = 0.02). The time spent in hypoglycaemia was higher in patients with HbA1C < 7% than those with HbA1C ≥ 8% (P = 0.015). Time spent <54 mg/dl was detected in 45% of patients. Conclusions We report a very high prevalence of hypoglycaemia, with a significant proportion of severe hypoglycaemia, in older institutionalised patients with diabetes taking potentially hypoglycaemia-inducing drugs. Having HbA1C < 7% exposes patients to a higher risk of hypoglycaemia, but this risk remains also high in patients with HbA1C ≥ 8%. In this population, continuous glucose monitoring could be considered an effective tool to detect hypoglycemia, which is associated with increased risk of cardiovascular events, falling, fractures, cognitive impairment and mortality.

中文翻译：

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连续血糖监测在老年糖尿病住院患者中检测到频繁和严重的低血糖

背景 对老年糖尿病患者低血糖的患病率知之甚少。然而，对于接受可导致低血糖治疗的住院患者，HbA1c 目标是≥8%。目的 我们旨在通过持续血糖监测评估低血糖的患病率，并评估老年住院糖尿病患者服用潜在的低血糖诱导药物与 HbA1C 的联系。设计 2019 年 1 月至 2020 年 7 月在法国科特多尔地区的六个老年护理中心进行的前瞻性、多中心研究。设置、对象和方法 在不知情的情况下佩戴 FreeStyle Libre Pro® (FSLP) 长达 14 天42 名服用至少一种潜在低血糖诱导抗糖尿病药物的患者的模式。结果 79% (n = 33) 佩戴 FSLP 的患者检测到 242 次低血糖事件。在 100% 的 HbA1C ＜ 100 的患者中检测到一种或多种低血糖事件。7% 和 79% 的 HbA1C ≥ 8% 的患者（P = 0.02）。HbA1C < 的患者发生低血糖的时间较长。比 HbA1C ≥ 8% 的患者高 7%（P = 0.015）。在 45% 的患者中检测到花费的时间小于 54 mg/dl。结论 我们报告了非常高的低血糖患病率，其中很大一部分是严重低血糖，在老年住院糖尿病患者中服用可能会引起低血糖的药物。HbA1C < 7% 使患者面临更高的低血糖风险，但在 HbA1C ≥ 8% 的患者中这种风险仍然很高。在这个人群中，