High number of hypoglycaemic episodes identified by CGM among home-dwelling older people with diabetes: an observational study in Norway
Open accessAbstract
Background: A scoping review from 2021 identified a lack of studies on the incidence, prevention and management of hypoglycaemia in home-dwelling older people with diabetes. The aim of this study was to investigate the frequency and duration of hypoglycaemic episodes measured by continuous glucose monitoring (CGM) in older people with diabetes who received home care and who were treated with glucose-lowering medications, and to compare the frequency and duration of hypoglycaemic episodes between subgroups of the study population according to demographic and clinical variables. Methods: This was an observational study investigating the occurrence of hypoglycaemia in people with diabetes aged ≥ 65 years. Data were collected using blinded continuous glucose monitoring (CGM, iPro2) for 5 consecutive days. Frequency and duration of hypoglycaemic episodes were assessed using a sensor glucose cut-off value of 3.9 mmol/L. A blood sample for measurement of HbA1c and creatinine-based eGFR (CKD-EPI) was obtained during the monitoring period. Demographic and clinical data were collected from electronic patient records. Results: Fifty-six individuals were enrolled (median age 82 years and 52% were men). Of the 36 participants who were treated with insulin, 33% had at least one hypoglycaemic episode during the five-day period. Among 18 participants who neither used insulin nor sulfonylurea, but other glucose-lowering medications, 44% had at least one hypoglycaemicepisode. Of those with hypoglycaemic episodes, 86% lived alone. The median duration of the hypoglycaemia was 1 h and 25 min, ranging from 15 min to 8 h and 50 min. Conclusion: This study identified an unacceptably high number of unknown hypoglycaemic episodes among older home-dwelling people with diabetes receiving home care, even among those not using insulin or sulfonylurea. The study provides essential knowledge that can serve as a foundation to improve the treatment and care for this vulnerable patient group. The routines for glucose monitoring and other prevention tasks need to be considered more comprehensively, also, among those treated with glucose-lowering medications other than insulin.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
An observational study of older adults with diabetes living in LTC facilities using CGM revealed a high prevalence of hypoglycemia both in people using insulin and in those using sulfonylureas, showing that this population is at increased risk for hypoglycemia.
“Furthermore, an observational study of older adults with diabetes living in LTC facilities using CGM revealed a high prevalence of hypoglycemia both in people using insulin and in those using sulfonylureas, thus showing that this population of older adults in LTC facilities are at increased risk for hypoglycemia (141).”
From 13. Older Adults: Standards of Care in Diabetes—2025 (2025) · cites this paper as [141]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredThis population of older adults in PALTC facilities is at increased risk for hypoglycemia.
“thus showing that this population of older adults in PALTC facilities are at increased risk for hypoglycemia (159,160).”
From 13. Older Adults: Standards of Care in Diabetes—2026 (2026) · cites this paper as [159]
The Background states that older home-dwelling people with diabetes have an increased risk of hypoglycaemia, and the Conclusion reports many episodes among people receiving home care. The study did not examine older adults living in PALTC facilities, so it does not directly support the claim for that setting. (LLM, conf=0.88)
Experimental — accuracy not yet measuredAdditional studies of older adults with diabetes living in PALTC facilities using CGM revealed a high prevalence of hypoglycemia both in people using insulin and in those using sulfonylureas.
“Additional studies of older adults with diabetes living in PALTC facilities using CGM revealed a high prevalence of hypoglycemia both in people using insulin and in those using sulfonylureas, thus showing that this population of older adults in PALTC facilities are at increased risk for hypoglycemia (159,160).”
From 13. Older Adults: Standards of Care in Diabetes—2026 (2026) · cites this paper as [159]
The Results and Discussion (page not provided) report CGM-detected hypoglycaemia in 33% of insulin users. But the participants were home-dwelling older adults receiving home care, not residents of PALTC facilities. The Discussion says only one participant with hypoglycaemia in the non-insulin group used a sulfonylurea, so the paper does not establish a high prevalence among sulfonylurea users. (LLM, conf=0.91)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
New creatinine- and cystatin C-based equations to estimate GFR without race
Inker, L. A., Eneanya, N. D., Coresh, J., Tighiouart, H., Wang, D., Sang, Y., Crews, D. C., Doria, A., Estrella, M. M., Froissart, M., et al. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2102953 · Cited by 4,695 · see citing works
Battelino, T., Danne, T., Bergenstal, R. M., Amiel, S. A., Beck, R., Biester, T., Bosi, E., Buckingham, B. A., Cefalu, W. T., Close, K. L., et al. (2019) · Diabetes Care · doi:10.2337/dci19-0028 · Cited by 4,032 · see citing works
International consensus on use of continuous glucose monitoring
Danne, T., Nimri, R., Battelino, T., Bergenstal, R. M., Close, K. L., DeVries, J. H., Garg, S., Heinemann, L., Hirsch, I., Amiel, S. A., et al. (2017) · Diabetes Care · doi:10.2337/dc17-1600 · Cited by 2,069 · see citing works
Davies, M. J., Aroda, V. R., Collins, B. S., Gabbay, R. A., Green, J., Maruthur, N. M., Rosas, S. E., Del Prato, S., Mathieu, C., Mingrone, G., et al. (2022) · Diabetologia · doi:10.1007/s00125-022-05787-2 · Cited by 1,048 · see citing works
6. Glycemic Targets: <i>Standards of Medical Care in Diabetes—2021</i>
American Diabetes Association (2021) · Diabetes Care · doi:10.2337/dc21-s006 · Cited by 847 · see citing works
Continuous glucose monitoring and metrics for clinical trials: an international consensus statement
Battelino, T., Alexander, C. M., Amiel, S. A., Arreaza-Rubin, G., Beck, R. W., Bergenstal, R. M., Buckingham, B. A., Carroll, J., Ceriello, A., Chow, E., et al. (2023) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(22)00319-9 · Cited by 831 · see citing works
Hypoglycemia in Older People - A Less Well Recognized Risk Factor for Frailty
Abdelhafiz, A. H., Rodríguez‐Mañas, L., Morley, J. E., & Sinclair, A. J. (2015) · Aging and Disease · doi:10.14336/ad.2014.0330 · Cited by 346 · see citing works
Shah, V. N., DuBose, S. N., Li, Z., Beck, R. W., Peters, A. L., Weinstock, R. S., Kruger, D., Tansey, M., Sparling, D., Woerner, S., et al. (2019) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2018-02763 · Cited by 315 · see citing works
Feinkohl, I., Aung, P. P., Keller, M., Robertson, C. M., Morling, J. R., McLachlan, S., Deary, I. J., Frier, B. M., Strachan, M. W. J., Price, J. F., et al. (2014) · Diabetes Care · doi:10.2337/dc13-1384 · Cited by 266 · see citing works
The Mini Nutritional Assessment®—Its History, Today's Practice, and Future Perspectives
Bauer, J. M., Kaiser, M., Anthony, P. S., Guigoz, Y., & Sieber, C. C. (2008) · Nutrition in Clinical Practice · doi:10.1177/0884533608321132 · Cited by 243 · see citing works
12. Older Adults: Standards of Medical Care in Diabetes—2020
American Diabetes Association (2019) · Diabetes Care · doi:10.2337/dc20-s012 · Cited by 226 · see citing works
Frequent Hypoglycemia Among Elderly Patients With Poor Glycemic Control
Munshi, M. N. (2011) · Archives of Internal Medicine · doi:10.1001/archinternmed.2010.539 · Cited by 196 · see citing works
Beck, A. M., & Ovesen, L. (1998) · Clinical Nutrition · doi:10.1016/s0261-5614(98)80058-7 · Cited by 196 · see citing works
Altered Hierarchy of Protective Responses Against Severe Hypoglycemia in Normal Aging in Healthy Men
Matyka, K., Evans, M., Lomas, J., Cranston, I., Macdonald, I., & Amiel, S. A. (1997) · Diabetes Care · doi:10.2337/diacare.20.2.135 · Cited by 195 · see citing works
Heinemann, L., Schoemaker, M., Schmelzeisen-Redecker, G., Hinzmann, R., Kassab, A., Freckmann, G., Reiterer, F., & Del Re, L. (2020) · Journal of Diabetes Science and Technology · doi:10.1177/1932296819855670 · Cited by 170 · see citing works
Thorpe, C. T., Gellad, W. F., Good, C. B., Zhang, S., Zhao, X., Mor, M., & Fine, M. J. (2015) · Diabetes Care · doi:10.2337/dc14-0599 · Cited by 140 · see citing works
Hypoglycemia in Type 2 Diabetes - More Common Than You Think
Gehlaut, R. R., Dogbey, G. Y., Schwartz, F., Marling, C. R., & Shubrook, J. H. (2015) · Journal of Diabetes Science and Technology · doi:10.1177/1932296815581052 · Cited by 131 · see citing works
Lee, A. K., Rawlings, A. M., Lee, C. J., Gross, A. L., Huang, E. S., Sharrett, A. R., Coresh, J., & Selvin, E. (2018) · Diabetologia · doi:10.1007/s00125-018-4668-1 · Cited by 115 · see citing works
Accuracy of the Enlite 6-Day Glucose Sensor with Guardian and Veo Calibration Algorithms
Keenan, D. B., Mastrototaro, J. J., Zisser, H., Cooper, K. A., Gautham, R., Lee, S. W., Yusi, J., Bailey, T. S., Brazg, R., & Shah, R. V. (2011) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2011.0199 · Cited by 99 · see citing works
Semlitsch, T., Engler, J., Siebenhofer, A., Jeitler, K., Berghold, A., & Horvath, K. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005613.pub4 · Cited by 80 · see citing works
Mattishent, K., & Loke, Y. K. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.571568 · Cited by 69 · see citing works
Presence of Macroalbuminuria Predicts Severe Hypoglycemia in Patients With Type 2 Diabetes
Yun, J., Ko, S.-H., Ko, S.-H., Song, K., Ahn, Y., Yoon, K., Park, Y., & Ko, S. (2012) · Diabetes Care · doi:10.2337/dc12-1408 · Cited by 64 · see citing works
Hambling, C. E., Seidu, S., Davies, M. J., & Khunti, K. K. (2017) · Diabetic Medicine · doi:10.1111/dme.13380 · Cited by 63 · see citing works
Çöpür, S., Onal, E. M., Afşar, B., Ortíz, A., van Raalte, D. H., Cherney, D. Z. I., Rossing, P. R., & Kanbay, M. (2020) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2020.107707 · Cited by 52 · see citing works
Boureau, A., Guyomarch, B., Gourdy, P., Allix, I., Annweiler, C., Cervantes, N., Chapelet, G., Delabrière, I., Guyonnet, S., Litke, R. R., et al. (2023) · Journal of the American Geriatrics Society · doi:10.1111/jgs.18341 · Cited by 40 · see citing works
Mattishent, K., & Loke, Y. K. (2018) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2018.05.005 · Cited by 38 · see citing works
Hypoglycaemia in older home-dwelling people with diabetes- a scoping review
Hermann, M., Heimro, L. S., Haugstvedt, A., Hernar, I., Sigurðardóttir, Á. K., & Graue, M. (2021) · BMC Geriatrics · doi:10.1186/s12877-020-01961-6 · Cited by 29 · see citing works
Self-citationDavies, M. J., Aroda, V. R., Collins, B. S., Gabbay, R. A., Green, J., Maruthur, N. M., Rosas, S. E., Prato, S. D., Mathieu, C., Mingrone, G., et al. (2022) · doi:10.2337/figshare.20800537.v1 · Cited by 29 · see citing works
Continuous Glucose Monitoring–Derived Data Report—Simply a Better Management Tool
Battelino, T., & Bergenstal, R. M. (2020) · Diabetes Care · doi:10.2337/dci20-0032 · Cited by 27 · see citing works
Davies, T. T., Graue, M., Igland, J., Tell, G. S., Birkeland, K. I., Peyrot, M. F., & Haltbakk, J. (2018) · Diabetic Medicine · doi:10.1111/dme.13790 · Cited by 24 · see citing works
Self-citationAssessment of the Glucose Management Indicator Using Different Sampling Durations
Bailey, R. J., Calhoun, P. M., Bergenstal, R. M., & Beck, R. W. (2022) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2022.0284 · Cited by 22 · see citing works
Hypoglycemia During Therapy of Diabetes
Spanakis, E. K., Cryer, P. E., & Davis, S. N. (2015) · Europe PMC (PubMed Central) · Cited by 21 · see citing works
Continuous glucose monitoring in older people with diabetes receiving home care—a feasibility study
Larsen, A. B., Hermann, M., & Graue, M. (2021) · Pilot and Feasibility Studies · doi:10.1186/s40814-020-00754-3 · Cited by 19 · see citing works
Self-citationDejager, S., Penfornis, A., Fiquet, B., & Blicklé, J. F. (2015) · Diabetes Metabolic Syndrome and Obesity · doi:10.2147/dmso.s83897 · Cited by 15 · see citing works
Baretić, M., & Lang, V. B. (2020) · BMC Endocrine Disorders · doi:10.1186/s12902-020-0518-5 · Cited by 13 · see citing works
Runesson, B., Xu, Y., Qureshi, A. R., Lindholm, B., Barany, P. F., Elinder, C. G., & Carrero, J. J. (2020) · Diabetes Obesity and Metabolism · doi:10.1111/dom.14051 · Cited by 11 · see citing works
Okel, A. E., Arbagy, A. R. E., Yassein, Y. S., Khodir, S., & Kasem, H. E. (2019) · Journal of The Egyptian Society of Nephrology and Transplantation · doi:10.4103/jesnt.jesnt_2_19 · Cited by 10 · see citing works
Haugstvedt, A., Graue, M., Aarflot, M., Heimro, L. S., Johansson, H., Hjaltadóttir, I., & Sigurðardóttir, Á. K. (2016) · International Diabetes Nursing · doi:10.1080/20573316.2016.1262588 · Cited by 9 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
13. Older Adults: Standards of Care in Diabetes—2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Echouffo-Tcheugui, J. B., Ekhlaspour, L., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s013 · Cited by 209 · see citing works
13. Older Adults: Standards of Care in Diabetes—2026
American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., et al. (2026) · Diabetes Care · doi:10.2337/dc26-s013 · Cited by 87 · see citing works
Individualized treatment of diabetes mellitus in older adults
Araki, A. (2024) · Geriatrics & Gerontology International · doi:10.1111/ggi.14979 · Cited by 32 · see citing works
Idrees, T., Castro-Revoredo, I. A., Oh, H. D., Gavaller, M. D., Zabala, Z., Moreno, E., Moazzami, B., Galindo, R. J., Vellanki, P., Cabb, E., et al. (2024) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2024.01.031 · Cited by 22 · see citing works
Kotecha, P., Smith, S. M., Donahoo, W. T., DeKosky, S. T., Bian, J., & Guo, J. S. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.41939 · Cited by 9 · see citing works
Lei, M., Zhou, Y., Ni, Y., Lin, Z., Lin, Q., Ling, P., Yang, D., Xu, W., Deng, H., & Yan, J. (2025) · Diabetes Obesity and Metabolism · doi:10.1111/dom.70355 · Cited by 8 · see citing works
O'Donnell, D. J. P., Burns, S., Drever, S., Quesnelle, L., & Yuen, B. (2025) · JMIR Diabetes · doi:10.2196/73485 · Cited by 2 · see citing works
Ergin, B. D., Gadsby-Davis, K., Mattishent, K., Dhatariya, K., Minihane, A., & Hornberger, M. (2025) · Journal of Diabetes Science and Technology · doi:10.1177/19322968251384992 · Cited by 2 · see citing works
Teigland, T., Igland, J., Graue, M., Blytt, K. M., Haltbakk, J., Tell, G. S., Birkeland, K. I., Østbye, T., Kirkevold, M., & Iversen, M. M. (2024) · BMC Geriatrics · doi:10.1186/s12877-024-05403-5 · Cited by 2 · see citing works
Self-citationTeigland, T., Igland, J., Blytt, K. M., Haltbakk, J., Birkeland, K. I., Østbye, T., Kirkevold, M., & Iversen, M. M. (2025) · BMC Geriatrics · doi:10.1186/s12877-025-06685-z · Cited by 1 · see citing works
Self-citationAslestad, A. M. V., Haugstvedt, A., & Hermann, M. (2026) · BMC Geriatrics · doi:10.1186/s12877-026-07414-w · Cited by 1 · see citing works
Self-citationFløde, M., Hermann, M., Igland, J., Hernar, I., Sigurðardóttir, Á. K., Søfteland, E. W., Åsberg, A., Jenssen, T. G., & Haugstvedt, A. (2025) · BMC Geriatrics · doi:10.1186/s12877-025-06732-9
Self-citationKompetanseheving og systematisk diabetesoppfølging i primærhelsetjenesten – sykepleieres erfaringer
Andorsen, A.-K. H., Joakimsen, R. M., & Moe, C. F. (2025) · Sykepleien Forskning · doi:10.4220/sykepleienf.2025.101668
Andorsen, A.-K. H., Joakimsen, R. M., & Moe, C. F. (2026) · Sykepleien Forskning · doi:10.4220/sykepleienf.2025.101668en
Czupryniak, L., Mysliwiec, M., Gellert, R., Jankowski, P., Mastalerz–Migas, A., Strojek, K., Walczak, M., & Targowski, T. (2026) · Endocrine Practice · doi:10.1016/j.eprac.2026.10.010
- Authors
- Fløde, M., Hermann, M., Haugstvedt, A., Søfteland, E., Igland, J., Åsberg, A., Jenssen, T. G., & Graue, M.
- Affiliations
- Western Norway University of Applied Sciences (NO)
- Haukeland University Hospital (NO)
- Oslo University Hospital (NO)
- Corresponding author
- Graue, Marit
- ORCID
- Venue
- BMC Endocrine Disorders
- Published
- 2023-10-10
- Volume
- 23
- Issue
- 1
- Pages
- 218-218
- ISSN
- 1472-6823 (ISSN-L)
- PMC
- PMC10566065
- OpenAlex
- W4387496085
- Cited by
- 15
- References
- 38
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 4
- FWCI
- 3.08
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Endocrine Disorders (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Duo Research Archive (University of Oslo) (submittedVersion, cc-by)
- Funders
- Høgskulen på Vestlandet
- Diabetesforbundet
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- hypoglycemia, diabetes in older adults, home-dwelling older people, home care, continuous glucose monitoring, hypoglycaemic episodes, insulin, sulfonylureas, glucose-lowering medications, living alone, hypoglycemia prevention
- MeSH terms
- Aged, Aged, 80 and over, Blood Glucose, Diabetes Mellitus, Type 1, Female, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Male, Sulfonylurea Compounds, Blood Glucose Self-Monitoring
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
