Bi-directional interaction between hypoglycaemia and XXXX in elderly @entity1 treated with @entity413 -lowering agents: a systematic review and meta-analysis.

@entity1 @entity6 @entity303 @entity73 @entity413
AIMS: To examine the bi-directional relationship, whereby hypoglycaemia is a risk factor for @entity303 , and where @entity303 increases risk of hypoglycaemia in older @entity1 with @entity6 treated with @entity413 -lowering agents. METHODS: We searched MEDLINE and EMBASE over a 10-year span from 2005 to 2015 (with automated PubMed updates to August 2015) for observational studies of the association between hypoglycaemia and @entity73 or @entity303 in @entity1 aged >55   years. Assessment of study validity was based on ascertainment of hypoglycaemia, @entity303 and risk of confounding. We conducted random effects inverse variance meta-analyses, and assessed heterogeneity using the I(2) statistic. RESULTS: We screened 1177 citations, and selected 12 studies, of which nine were suitable for meta-analysis. There were a total of 1   439   818 @entity1 , with a mean age of 75   years. Meta-analysis of five studies showed a significantly increased risk of @entity303 in @entity1 who had hypoglycaemic episodes: pooled odds ratio 1.68 [95% confidence interval (CI) 1.45, 1.95]. We also found a significantly increased risk of hypoglycaemia in @entity1 with @entity303 : pooled odds ratio from five studies 1.61 (95% CI 1.25, 2.06). Limitations of the study were heterogeneity in the meta-analysis, and uncertain ascertainment of @entity303 and hypoglycaemic outcomes and temporal relationships. Publication bias may have favoured the reporting of more significant findings. CONCLUSIONS: Our meta-analysis shows a bi-directional relationship between @entity73 and hypoglycaemia in older @entity1 . @entity413 -lowering therapy should be carefully tailored and monitored in older @entity1 who are susceptible to @entity73 .
