Introduction: The Growing Challenge of Hypoglycemia in Aging Populations
As the lifespan of individuals with Type 1 Diabetes (T1D) continues to increase, clinicians face the complex challenge of managing glycemic control in an aging population. Older adults are disproportionately affected by impaired awareness of hypoglycemia (IAH), a condition characterized by a diminished ability to perceive the autonomic and neuroglycopenic symptoms of falling blood glucose. IAH is a potent risk factor for severe hypoglycemic events (SHEs), which in older patients can lead to falls, fractures, cognitive decline, and cardiovascular stress. While Continuous Glucose Monitoring (CGM) has become the gold standard for reducing hypoglycemia, its ability to actually reverse or improve the underlying physiological deficit of IAH in older adults remains a subject of intense clinical debate.
