Objectives: To investigate patients' views about their lowest tolerable blood glucose level and explore symptoms they may develop below that level.
Design: A semi-structured patient interview.
Setting: Outpatient clinic for older people (≥75 years) with diabetes.
Participants: Patients attending an outpatient clinic over a six months period who are monitoring their blood glucose at home and able to participate in interview.
Results: Sixty one patients gave answers to the interview questions. Mean (SD) age was 82.3 (3.9) years and 33 (54%) were females. All patients indicated that they were usually aware when hypoglycaemia occurs but the symptoms reported were mostly non specific. The threshold for hypoglycaemia was 5 mmol/L in 13 (21%) patients, 6 mmol/L in 14 (23%) patients, 7 mmol/L in 13 (21%) patients, 8 mmol/L in 17 (28%) patients and 9 mmol/L in 4 (7%) patients. There was no significant difference between patients who were symptomatic at a higher blood glucose level (>6 mmo/L) and those who developed symptoms at a lower level (≤6 mmol/L).
Conclusion: Older people with diabetes who seem to be aware of hypoglycaemia report mostly non specific symptoms. The threshold of experiencing hypoglycaemic symptoms appears to be higher than the usually defined <4 mmol/L.