[The role of glomerular filtration rate in assessing the risk of hypoglycemia in elderly patients with type 2 diabetes mellitus.]

Type 2 Diabetes Mellitus (T2DM) is highly prevalent among elderly patients. One of the primary target organs for T2DM is the kidneys. The aim of this study was to investigate the relationship between reduced kidney function and the risk of hypoglycemia in elderly female patients with T2DM and to develop a predictive model for this risk. The study included 150 female patients aged 60-74 years with T2DM, among whom hypoglycemia was observed in 58 (38,7%) patients. The medical history of T2DM, dynamic blood glucose levels, glycated hemoglobin (HbA1c), serum creatinine, and estimated glomerular filtration rate (eGFR) using the CKD-EPI formula were analyzed. Statistically significant differences were found between the study groups in terms of T2DM duration, eGFR, minimum and final blood glucose levels (all p<0,001), as well as maximum glucose levels and HbA1c (p=0,005). Patients with hypoglycemia more frequently had chronic kidney disease. A direct correlation was observed between eGFR and minimum (p<0,001) and last (p=0,041) blood glucose levels. Multivariate logistic regression analysis confirmed that decreased eGFR and duration of T2DM are significant risk factors for hypoglycemia. Based on this method, a diagnostic model for assessing hypoglycemia risk was developed. A ROC curve was constructed (AUC=0,884, p<0,001), with a logistic function cutoff value of 0,38 (indicating a 38% hypoglycemia risk) selected as the threshold. Thus, decreased eGFR and duration of T2DM are predictors of hypoglycemia in elderly patients with T2DM.