Diabetes treatment and hypoglycaemic episodes in elderly patients at nursing homes in Uppsala County

  • Angelica Walfridsson Östervåla Primary Health Care Centre, Östervåla, Sweden
  • Maja Sehlberg Uppsala University, Faculty of Biomedicine, Uppsala, Sweden
  • Ulrika Gillespie Uppsala University Hospital (Akademiska Sjukhuset), Uppsala, Sweden
  • Jonathan Dahlkvist Uppsala Läns Landsting, Uppsala, Sweden
  • Hans-Erik Johansson Östervåla Primary Health Care Centre, Östervåla, Sweden; and Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
Keywords: Diabetes medication, elderly patients, HbA1c, hypoglycaemia, nursing homes


Aim: The aim of this study was to examine the situation for elderly patients with diabetes living in nursing homes with regard to diabetes treatment, clinical variables, and vascular complications associated with diabetes. A second aim was to evaluate if the patients were at risk of hypoglycaemia.

Methods: This was a cross-sectional study including diabetes patients from all 30 nursing homes in Uppsala County, Sweden. Current antidiabetic medications, HbA1c, hypoglycaemic events, and diabetes complications were registered from the medical records. The patients were stratified into a general group and divided into three groups according to HbA1c (<52, 52–73, and >73 mmol/mol).

Results: Of 1,350 individuals, 218 patients were identified with diabetes mellitus. The diabetes duration was 11.2 ± 9.4 years and their serum HbA1c concentration 56.0 ± 1.2 mmol/mol. Hypoglycaemic events were reported in 24% of the diabetic individuals, and 43.1% of them had HbA1c <52 mmol/mol (mean value 44.0 ± 1.1 mmol/mol). Of these, 36% were taking antidiabetic drugs. Another 35.8% of the patients had HbA1c values between 52–73 mmol/mol (mean value 60.0 ± 1.1 mmol/mol), and 82% of these patients were taking antidiabetic drugs. Almost 80% of the diabetic patients had either micro- or macrovascular complications, with diabetes duration as an association for both micro- or macrovascular complications and hypoglycaemic events.

Conclusions: A reduction of the use of antidiabetic drugs with follow-up of HbA1c level should be considered, especially for multimorbid elderly patients with low HbA1c and hypoglycaemia.


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How to Cite
Walfridsson A., Sehlberg M., Gillespie U., Dahlkvist J., & Johansson H.-E. (2016). Diabetes treatment and hypoglycaemic episodes in elderly patients at nursing homes in Uppsala County. Upsala Journal of Medical Sciences, 121(3), 179–183. https://doi.org/10.1080/03009734.2016.1198441
Original Articles