de Decker L, et al. - The researchers conducted this cross-sectional, population-based study to decide whether a high burden of comorbidities was correlated with hypoglycemia in very old patients with type 2 diabetes (T2D). Among older vulnerable patients with T2D, a high burden of comorbidities was independently associated with hypoglycemia, in addition to insulin therapy.

• The researchers recruited 1552 elderly (age ≥ 80 years old) patients with T2D in a nationwide cross-sectional study performed in French geriatric care units.
• They defined hypoglycemia as a confirmed blood glucose value level ≤ 70 mg/dL.
• Using the Charlson Comorbidity Index (CCI), comorbidities were evaluated.

• The researchers found documented hypoglycemia in 415 (26.7%) patients, amongst the 1552 recruited patients (mean age 86.4 years).
• Patients with hypoglycemia had a lower body weight (p=0.004), a reduced eGFR (p < 0.001), a greater level of dependency (p < 0.001) as well as history of dementia (p=0.006) and cardiovascular disease (p < 0.001), and a higher CCI (4.7 vs 3.8, p < 0.001) compared to patients in whom hypoglycemia was not reported.
• With reduced sulfonylurea use (p < 0.001), patients with hypoglycemia had a higher frequency of daily self-monitoring blood glucose (SMBG) (p < 0.001) and insulin use (p < 0.001).
• Factors independently associated with the risk of hypoglycemia were insulin therapy (OR 3.32, p < 0.001), daily SMBG (OR 1.79, p=0.02), CCI (OR 1.24, p=0.01), and age (OR 0.96, p=0.03) in multivariate logistic regression analysis.