Hypoglycemia in older adults with type 2 diabetes mellitus: Prevalence and associated risk factor: A systematic review and meta-analysis.

BACKGROUND

Currently, hypoglycemia poses a critical challenge in managing older patients with type 2 diabetes mellitus (T2DM), threatening their long-term health and overall well-being. This meta-analysis is the first to comprehensively quantify the pooled prevalence of hypoglycemia and identify its key influencing factors specifically in the elderly population.

METHODS

We conducted a systematic study across 11 databases to identify relevant observational studies reporting the prevalence of hypoglycemia or its influencing factors. The search was limited from database inception all the way until July 9th, 2025, and updated November 13th, 2025. In addition, we conducted a meta-analysis of the overall prevalence of hypoglycemia and its influencing factors using Stata 17.0 and RevMan 5.4, respectively.

RESULTS

Among the 37 studies included, the overall prevalence of hypoglycemia in elderly patients with T2DM was 21% (95%CI, 20-23%). The results of this meta-analysis showed that age, diabetes duration, insulin treatment, hypertension, malignant tumors, renal impairment, cognitive dysfunction, and glycosylated hemoglobin were the key determinants influencing the risk of hypoglycemia in the elderly T2DM population.

CONCLUSION

Early clinical risk assessment is essential for older adults with type 2 diabetes mellitus at high risk of hypoglycemic complications, along with the implementation of evidence-based diagnostic and therapeutic protocols for hypoglycemia management.