Introduction and Objective: The risk of hypoglycemia increases with age and medical complexity. Recent trends in the epidemiology of hypoglycemia among older adults with diabetes have not been previously evaluated.Methods: We conducted an annual repeated cross-sectional cohort study from 2017-2024 in Epic Cosmos, a nationwide database of electronic health records of more than 300 million patients from over 1,854 hospitals and 42,200 clinics. Patients with a history of diabetes mellitus were identified via a validated algorithm. Rates of prevalent hypoglycemia, defined as at least one diagnosis in the two years preceding the index date, and incident hypoglycemia, defined as a new diagnosis of hypoglycemia without a diagnosis in the preceding two years, with sensitivity analyses restricting to codes in the inpatient setting and as the primary diagnosis, were calculated annually and age-sex standardized.Results: In total, between 2,391,060 (in 2017) and 6,204,836 (in 2024) older adults with diabetes mellitus were included, of whom 91,800 and 323,879, respectively, had prevalent hypoglycemia, and 42,161 and 117,957 had incident hypoglycemia. Trends in hypoglycemia, overall and stratified by subgroup, are shown in Figure 1.Conclusion: The incidence and prevalence of hypoglycemia among older adults increased from 2017-2024, highlighting the need to further optimize antiglycemic treatment patterns for older adults.
P. Madala: None. C. Powell: None. E. OBrien: Research Support; Current; Pfizer Inc. F. Li: None. B. Mac Grory: None. J.B. Lusk: None.
National Institutes of Health (P30AG072958)
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