{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T12:16:06Z","timestamp":1792844166826,"version":"4.5.0"},"reference-count":52,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,3,25]],"date-time":"2023-03-25T00:00:00Z","timestamp":1679702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004339","name":"Sanofi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004339","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is a lack of real\u2010life data regarding the frequency and predictive factors of hypoglycemia in older patients with type 2 diabetes (T2D). This study aimed to determine the frequency and predictors of hypoglycemia in older patients with insulin\u2010treated T2D.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This prospective multicenter study included 155 insulin\u2010treated T2D patients aged 75\u2009years and older with \u22652 self\u2010monitoring of blood glucose (SMBG) daily controls. Participants underwent a geriatric and diabetic assessment and received ambulatory blinded continuous glucose monitoring (CGM) for 28 consecutive days with FreeStyle Libre Pro\u00ae sensor. Study population (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0141) has &gt;70% CGM active time. Multivariable logistic regressions were used to identify factors associated with SMBG confirmed hypoglycemia (\u226570\u2009mg\/dL) and with nocturnal level 2 time below range (glucose concentration &lt;54\u2009mg\/dL during \u226515 consecutive min between 0.00 and 6.00\u2009am).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean age of the 141 analyzed patients was 81.5\u2009\u00b1\u20095.3\u2009years and 56.7% were male. The mean baseline HbA\n                      <jats:sub>1c<\/jats:sub>\n                      was 7.9%\u2009\u00b1\u20091.0%. After geriatric assessment, 102 participants (72.3%) were considered as complex and 39 (27.7%) as healthy. The primary endpoint (confirmed SMBG &lt;70\u2009mg\/dL) occurred in 37.6% patients. In multivariable analysis, the risk of SMBG\u2010confirmed hypoglycemia was positively associated with a longer duration of diabetes (OR (+1\u2009year) =1.04, (1.00\u20131.08),\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.04) and glycemic variability assessed by CGM (CV %) (OR (+1%)\u00a0=\u00a01.12, [1.05\u20131.19],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0&lt;0.001). Nighty\u2010two patients (65.2%) experienced nocturnal time in hypoglycemia (i.e., &lt;54\u2009mg\/dL during \u226515 consecutive min between midnight and 6\u2009a.m.). In multivariable analyses, cognitive impairment (OR: 9.31 [2.59\u201333.4]), heart failure (OR: 4.81 [1;48\u201315.6]), and depressive disorder (OR: 0.19 [0.06\u20130.53]) were associated with nocturnal time in hypoglycemia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Nocturnal hypoglycemia is very common and largely underdiagnosed in older patients with insulin\u2010treated T2D. CGM is a promising tool to better identify hypoglycemia and adapt diabetes management in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.18341","type":"journal-article","created":{"date-parts":[[2023,3,25]],"date-time":"2023-03-25T16:05:54Z","timestamp":1679760354000},"page":"2107-2119","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Nocturnal hypoglycemia is underdiagnosed in older people with insulin\u2010treated type 2 diabetes: The\n                    <scp>HYPOAGE<\/scp>\n                    observational study"],"prefix":"10.1111","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2224-2014","authenticated-orcid":false,"given":"Anne\u2010Sophie","family":"Boureau","sequence":"first","affiliation":[{"name":"Nantes Universit\u00e9, CHU Nantes, Pole de G\u00e9rontologie Clinique  Nantes F\u201044000 France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9atrice","family":"Guyomarch","sequence":"additional","affiliation":[{"name":"Nantes Universit\u00e9, CHU Nantes, CNRS, INSERM, l'institut du thorax  Nantes F\u201044000 France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Gourdy","sequence":"additional","affiliation":[{"name":"CHU de Toulouse &amp; UMR1297\/I2MC, Universit\u00e9 de Toulouse  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Allix","sequence":"additional","affiliation":[{"name":"D\u00e9partement d'Endocrinologie Diab\u00e9tologie, Nutrition, CHU de Angers  Angers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9dric","family":"Annweiler","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine and Memory Clinic Research Center on Autonomy and Longevity, University Hospital  Angers France"},{"name":"UPRES EA 4638, University of Angers  Angers France"},{"name":"G\u00e9rontop\u00f4le Autonomie Long\u00e9vit\u00e9 des Pays de la Loire  Nantes France"},{"name":"Robarts Research Institute, Department of Medical Biophysics Schulich School of Medicine and Dentistry, the University of Western Ontario  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Cervantes","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Sud Francilien  Corbeil\u2010Essonnes F\u201091100 France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Chapelet","sequence":"additional","affiliation":[{"name":"Nantes Universit\u00e9, CHU Nantes, Pole de G\u00e9rontologie Clinique  Nantes F\u201044000 France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Delabri\u00e8re","sequence":"additional","affiliation":[{"name":"CHU Lille, Geriatric Department  Lille 59000 France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Guyonnet","sequence":"additional","affiliation":[{"name":"Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse)  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Litke","sequence":"additional","affiliation":[{"name":"CHU Lille, Geriatric Department  Lille 59000 France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Paccalin","sequence":"additional","affiliation":[{"name":"CHU de Poitiers, P\u00f4le de g\u00e9riatrie  Poitiers 86021 France"},{"name":"Universit\u00e9 de Poitiers, INSERM, CHU Poitiers, Centre d'Investigation Clinique CIC 1402  Poitiers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Penfornis","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Sud Francilien, F\u201091100 Corbeil\u2010Essonnes, Universit\u00e9 Paris\u2010Saclay  France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre\u2010Jean","family":"Saulnier","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Poitiers, INSERM, CHU Poitiers, Centre d'Investigation Clinique CIC 1402  Poitiers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthieu","family":"Wargny","sequence":"additional","affiliation":[{"name":"Nantes Universit\u00e9, CHU Nantes, CNRS, INSERM, l'institut du thorax  Nantes F\u201044000 France"},{"name":"Nantes Universit\u00e9, CHU Nantes, P\u00f4le Hospitalo\u2010Universitaire 11: Sant\u00e9 Publique, Clinique des donn\u00e9es, INSERM  CIC 1413 Nantes F\u201044000 France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samy","family":"Hadjadj","sequence":"additional","affiliation":[{"name":"Nantes Universit\u00e9, CHU Nantes, CNRS, INSERM, l'institut du thorax  Nantes F\u201044000 France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laure","family":"de Decker","sequence":"additional","affiliation":[{"name":"Nantes Universit\u00e9, CHU Nantes, Pole de G\u00e9rontologie Clinique  Nantes F\u201044000 France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1580-8040","authenticated-orcid":false,"given":"Bertrand","family":"Cariou","sequence":"additional","affiliation":[{"name":"Nantes Universit\u00e9, CHU Nantes, CNRS, INSERM, l'institut du thorax  Nantes F\u201044000 France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,25]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Chronic diabetes affects millions of people in the EU. 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