Last year I wrote that Diabetes is better treated aggressively to avoid complications. True. However, when the diabetic patient becomes an elderly, this may not be so.
I had several cases admitted in the hospital, of elderly who suffered severe hypoglycemia after diligently taking their prescribed meds. One is 90 the other is 89. Hypoglycemia should be watched out among our elderly patients. They may not manifest as simple tremors or dizziness. My 90 year old patient had a very good appetite when I left her after my rounds. She even thanked me for taking care of her. However, that night her sugar started to fluctuate. I had just discontinued her hypoglycemic drugs two days prior. Her sugar dropped down to less than 50 which prompted me to give D50's. She would respond well but after several hours, the sugar would drop again. The resident on duty just continued monitoring her glucose levels and managed accordingly. However, at 4AM, the ROD called to tell me that my patient died- suddenly- seated down. Relatives said she requested to be seated down so she can eat, after several minutes, she just closed her eyes and did not breathe. Altthough she was 90, I still felt deep inside that I should have sent her home so she could have rested in the arms of all her children.
I noticed hypoglycemic agents should be used with caution when patients become 60 and above. Their response to these agents is very unpredictable. Nowadays, when I see my elderly patients whose children complain that their sugar is high, except when there are other signs and symptoms, I tell them to observe and not to feel alarmed. It is better to have higher sugar levels when you're old old. Monitoring of sugar levels is recommended.
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