Abstract
BackgroundHypoglycaemia is associated with cognitive and functional decline in older people with diabetes. Identification of individuals at risk and prevention of hypoglycaemia is therefore an important task in the management of diabetes in older home-dwelling individuals. The purpose of this scoping review was to map the literature on hypoglycaemia in home-dwelling older people with diabetes.MethodsThis scoping review included original research articles on hypoglycaemia in older (≥ 65 years) individuals with diabetes from developed countries. A broad search of the databases Cinahl, Embase and Medline was performed in July 2018. The report of the scoping review was conducted in accordance with the PRISMA Extension for Scoping Reviews.ResultsOur database search identified 577 articles of which 23 were eligible for inclusion. The identified literature was within four areas: 1) incidence of hypoglycaemia in older home-dwelling people with diabetes (11/23 articles), 2) risk factors of hypoglycaemia (9/23), 3) diabetes knowledge and self-management (6/23) and 4) consequences of hypoglycaemia for health care use (6/23). The majority of the literature focused on severe hypoglycaemia and the emergency situation. The literature on diabetes knowledge and management related to preventing adverse events relevant to older home-dwellers, was limited. We found no literature on long-term consequences of hypoglycaemia for the use of home health care services and the older persons’ ability to remain home-dwelling.ConclusionsWe identified a lack of studies on prevention and management of hypoglycaemia in the older individuals’ homes. Such knowledge is of utmost importance in the current situation where most western countries’ governmental policies aim to treat and manage complex health conditions in the patient’s home. Future studies addressing hypoglycaemia in older individuals with diabetes are needed in order to tailor interventions aiming to enable them to remain home-dwelling as long as possible.
Highlights
Hypoglycaemia is associated with cognitive and functional decline in older people with diabetes
We have previously demonstrated a significant discrepancy between diabetes guideline recommendations and clinical practice with respect to glucose monitoring, individualized treatment goals for Haemoglobin A1c (HbA1c) and documentation in nursing homes [23]
Data from the individual sources of evidence were within the following areas: 1) incidence of hypoglycaemia in older home-dwelling people with diabetes, 2) risk factors of hypoglycaemia, 3) diabetes knowledge and selfmanagement, and 4) consequences of hypoglycaemia for health care use (Table 1)
Summary
Hypoglycaemia is associated with cognitive and functional decline in older people with diabetes. Identification of individuals at risk and prevention of hypoglycaemia is an important task in the management of diabetes in older home-dwelling individuals. Episodes of severe hypoglycaemia increase the risk of major cardiovascular events, cardiovascular death and all-cause mortality [5, 6]. The risk of hypoglycaemia increases with increasing age and the consequences for older people with diabetes may even be more severe, because falls and fractures are often followed by functional decline [7]. The general recommendation on glycaemic control in older individuals is that hypoglycaemia should be avoided in order to prevent further cognitive and functional decline and other major adverse outcomes, such as cardiovascular events [16]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
