PERCEIVED SYMPTOMS OF HYPOGLYCEMIA IN ELDERLY TYPE-2 DIABETIC-PATIENTS TREATED WITH INSULIN

Elderly insulin-treated diabetic patients have a high risk of severe h ypoglycaemia, yet their hypoglycaemic symptom profile has attracted li ttle research. In this study, the frequency and intensity of symptoms of hypoglycaemia were recorded using a validated questionnaire in 132 insulin-treated diabetic patients, aged 70 years or more. Principal co mponents analysis (PCA) was used to discover the factorial structure o f the symptoms. Lightheadedness and unsteadiness were prominent sympto ms in the elderly patients. PCA suggested three separate groups of sym ptoms: (1) those related specifically to impairment of co-ordination a nd articulation; (2) more general neuroglycopenic symptoms, and (3) au tonomic symptoms. The frequency and classification of hypoglycaemic sy mptoms in this elderly population is different from those seen in youn ger diabetic patients treated with insulin. Neurological symptoms of h ypoglycaemia were more commonly reported and may be misinterpreted as features of cerebrovascular disease. Health professionals and carers i nvolved in the treatment and education of diabetic patients should be aware of the age-specific differences in hypoglycaemic symptoms. (C) 1 998 John Wiley & Sons, Ltd.