Most of the time, the older woman seemed sharp. But increasingly, she became confused and disoriented — a case of “intermittent dementia,” one doctor speculated. Further tests were ordered, and then another diagnosis emerged.
It wasn’t dementia at all. It was hypoglycemia, or low blood sugar. The woman had diabetes and was taking too much medication. Once the doses were lowered, her cognitive symptoms disappeared.
Further evidence that hypoglycemia deserves more attention in older diabetes patients comes from another study published earlier this year, also in JAMA Internal Medicine. That report examined 72,310 patients with Type 2 diabetes aged 60 and older who were treated by Kaiser Permanente in Northern California. The study found that hypoglycemia was the third most common complicationin adults aged 70 and older who had had diabetes for at least 10 years.
The authors’ conclusion: “As long-term survivorship with diabetes increases and as the population ages, more research and public health efforts to reduce hypoglycemia will be needed.”
For older people with diabetes and their caregivers, the implications are clear. “Be on the lookout for symptoms of hypoglycemia, make sure you report these to your physician and be actively engaged in making treatment decisions,” Dr. Lipska said.