Abstract
Elderly diabeiics have diseases such as renal diabetic complications and cerebral arteriosclerosis that render their physical functioning different from young diabetics.
Therefore, attention should be given to physical functions in the treatment of elderly diabetics. We recently experienced six hypoglycemic cases (mean age: 80.7 years, insulin: 5 cases, oral hypoglycemic drugs: 1 case) who were not diagnosed as having, hypoglycemia because of the absence of typical signs.
The most remarkable clinical signs were disfunctions of the cerebral cortex including apathy, slow speech, change in penmanship, gait disturbance and lethargy.
In contrast, they showed few autonomic signs like sweating, palpitation and tremor.
EEG findings at admission revealed that basic waves were 7-8 c/s; some θ waves were seen in all leads without laterality, suggesting diffuse disfunction of the cerebral cortex.
The cases with insulin injection showed unrecognized nocturnal hypoglycemia which was diagnosed only by blood chemical analysis.
During hospitalization, clinical signs disappeared after decreased iusulin injection.
These findings were considered to indicate chronic hypoglycemia due to tight control of blood glucose by insulin or oral hypoglycemic drugs over a long period of time.
Accordingly, tight control of blood glucose must be avoided in elderly diabetics.
