Evaluating Latent Adrenal Insufficiency in Elderly Patients With Nocturnal Hypoglycemia: A Retrospective Observational Study

Objective: To evaluate the association between nocturnal hypoglycemia (NH) and latent adrenal insufficiency (LAI) among elderly aged >65 years.

Methods: This propensity-matched, retrospective observational study was conducted in an outpatient setting, assessing 1238 elderly aged >65 years between November 2017 and February 2020. Of them, 430 patients with unassessed LAI were monitored for NH using continuous glucose monitoring with Freestyle Libre Pro. The primary outcome was the combined prevalence of newly diagnosed and suspected LAI in patients with NH.

Results: After propensity score matching, 192 patients were included (96 each in the NH and non-NH group). The overall incidence rate of NH was 28.8% (124/430). The association of NH with newly diagnosed and suspected LAI was significantly higher in the NH group (26.04%, 50/192) than in the non-NH (12.5%, 24/192) (odds ratio: 3.26; 95% confidence interval: 2.59-9.06; P < .001). In the NH, compared with patients without LAI, those with new-diagnosed LAI had a higher incidence of hypoglycemia.

Conclusions: Diagnosing and treating LAI in the elderly with NH may prevent complications, including fatal diseases, and extend their life expectancy.