Hypoglycemia in older adults with type 2 diabetes mellitus: Prevalence and associated risk factor: A systematic review and meta-analysis

4区医学 Q3 Nursing

Endocrinologia, Diabetes y Nutricion Pub Date : 2026-05-01 Epub Date: 2026-01-27 DOI:10.1016/j.endinu.2025.501759

Yuelin Wang , Yunlan Jiang , Le Li , Hong Chen , Jing Wang , Mengjie Zhang , Xiaoyu Bai , Senlin Wu

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Abstract

Background

Currently, hypoglycemia poses a critical challenge in managing older patients with type 2 diabetes mellitus (T2DM), threatening their long-term health and overall well-being. This meta-analysis is the first to comprehensively quantify the pooled prevalence of hypoglycemia and identify its key influencing factors specifically in the elderly population.

Methods

We conducted a systematic study across 11 databases to identify relevant observational studies reporting the prevalence of hypoglycemia or its influencing factors. The search was limited from database inception all the way until July 9th, 2025, and updated November 13th, 2025. In addition, we conducted a meta-analysis of the overall prevalence of hypoglycemia and its influencing factors using Stata 17.0 and RevMan 5.4, respectively.

Results

Among the 37 studies included, the overall prevalence of hypoglycemia in elderly patients with T2DM was 21% (95%CI, 20–23%). The results of this meta-analysis showed that age, diabetes duration, insulin treatment, hypertension, malignant tumors, renal impairment, cognitive dysfunction, and glycosylated hemoglobin were the key determinants influencing the risk of hypoglycemia in the elderly T2DM population.

Conclusion

Early clinical risk assessment is essential for older adults with type 2 diabetes mellitus at high risk of hypoglycemic complications, along with the implementation of evidence-based diagnostic and therapeutic protocols for hypoglycemia management.

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老年2型糖尿病患者的低血糖：患病率和相关危险因素：一项系统回顾和荟萃分析

目前，低血糖是老年2型糖尿病（T2DM）患者治疗的一个关键挑战，威胁着他们的长期健康和整体福祉。这项荟萃分析首次全面量化了低血糖的综合患病率，并明确了低血糖在老年人群中的主要影响因素。方法对11个数据库进行系统研究，以确定低血糖患病率及其影响因素的相关观察性研究。搜索从数据库开始一直限制到2025年7月9日，并于2025年11月13日更新。此外，我们分别使用Stata 17.0和RevMan 5.4对低血糖的总体患病率及其影响因素进行了meta分析。结果在纳入的37项研究中，老年T2DM患者低血糖的总体患病率为21% （95%CI, 20-23%）。本荟萃分析结果显示，年龄、糖尿病病程、胰岛素治疗、高血压、恶性肿瘤、肾功能损害、认知功能障碍和糖化血红蛋白是影响老年T2DM人群低血糖风险的关键决定因素。结论对老年2型糖尿病低血糖并发症高危人群进行早期临床风险评估是必要的，同时实施循证诊断和治疗方案进行低血糖管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrinologia, Diabetes y Nutricion Nursing-Nutrition and Dietetics

CiteScore

2.10

自引率

0.00%

发文量

169

审稿时长

35 days

期刊介绍： Endocrinología, Diabetes y Nutrición is the official journal of the Spanish Society of Endocrinology and Nutrition (Sociedad Española de Endocrinología y Nutrición, SEEN) and the Spanish Society of Diabetes (Sociedad Española de Diabetes, SED), and was founded in 1954. The aim of the journal is to improve knowledge and be a useful tool in practice for clinical and laboratory specialists, trainee physicians, researchers, and nurses interested in endocrinology, diabetes, nutrition and related disciplines. It is an international journal published in Spanish (print and online) and English (online), covering different fields of endocrinology and metabolism, including diabetes, obesity, and nutrition disorders, as well as the most relevant research produced mainly in Spanish language territories. The quality of the contents is ensured by a prestigious national and international board, and by a selected panel of specialists involved in a rigorous peer review. The result is that only manuscripts containing high quality research and with utmost interest for clinicians and professionals related in the field are published. The Journal publishes Original clinical and research articles, Reviews, Special articles, Clinical Guidelines, Position Statements from both societies and Letters to the editor. Endocrinología, Diabetes y Nutrición can be found at Science Citation Index Expanded, Medline/PubMed and SCOPUS.