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BioMed Research International
Volume 2014, Article ID 906103, 7 pages
http://dx.doi.org/10.1155/2014/906103
Research Article

Hypoglycemia Is Independently Associated with Multidimensional Impairment in Elderly Diabetic Patients

1Geriatrics Unit, Azienda ULSS 16, S. Antonio Hospital, 35127 Padua, Italy
2CNR—Institute of Neuroscience, Aging Branch, Via Giustiniani 2, 35128 Padua, Italy
3Geriatrics Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, 71013 Foggia, Italy
4Department of Medicine, University of Padua, 35128 Padua, Italy
5Diabetology Unit, University of Turin, 10124 Turin, Italy
6Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme, 82037 Benevento, Italy

Received 18 October 2013; Accepted 6 January 2014; Published 13 February 2014

Academic Editor: Ali Rizvi

Copyright © 2014 A. Pilotto et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aim. To identify the characteristics associated with multidimensional impairment, evaluated through the Multidimensional Prognostic Index (MPI), a validated predictive tool for mortality derived from a standardized Comprehensive Geriatric Assessment (CGA), in a cohort of elderly diabetic patients treated with oral hypoglycemic drugs. Methods and Results. The study population consisted of 1342 diabetic patients consecutively enrolled in 57 diabetes centers distributed throughout Italy, within the Metabolic Study. Inclusion criteria were diagnosis of type 2 diabetes mellitus (DM), 65 years old or over, and treatment with oral antidiabetic medications. Data concerning DM duration, medications for DM taken during the 3-month period before inclusion in the study, number of hypoglycemic events, and complications of DM were collected. Multidimensional impairment was assessed using the MPI evaluating functional, cognitive, and nutritional status; risk of pressure sores; comorbidity; number of drugs taken; and cohabitation status. The mean age of participants was 73.3 ± 5.5 years, and the mean MPI score was 0.22 ± 0.13. Multivariate analysis showed that advanced age, female gender, hypoglycemic events, and hospitalization for glycemic decompensation were independently associated with a worse MPI score. Conclusion. Stratification of elderly diabetic patients using the MPI might help to identify those patients at highest risk who need better-tailored treatment.