Hypoglycemia in the elderly.

Fifty three elderly hypoglycemic patients seen at Tokyo Metropolitan Geriatric Hospital during last 4 years were reviewed, and these data suggest that clinical characteristics of hypoglycemic patients in the elderly are as follows: 1) Non-diabetics without any hypoglycemic drugs seem to take relatively large part in hypoglycemic patients; 2) malnutrition due to chronic disease, and liver dysfunction may be important predisposing factors in development of hypoglycemia; 3) they are often lacking in adrenergic symptoms and do not tend to present symptoms until their plasma glucose levels decrease at extremely low levels, moreover in such cases, they tend to manifest neuroglycopenia in the beginning of their hypoglycemic attacks. Therefore, it is noteworthy that impaired subjective recognition may increase the risk of hypoglycemia and hypoglycemia should be one of the important considerations in differential diagnosis of stupor and coma in the elderly patients, even though they have not been administered any hypoglycemic agents.