Frequent hypoglycemia among elderly patients with poor glycemic control.

TLDR: Raising HbA(1C) goals may not be adequate to prevent hypoglycemia in older adults with poor glycemic control, as 102 hypoglycemic episodes were unrecognized by finger-stick glucose measurements performed 4 times a day or by symptoms.

Abstract: Background Episodes of hypoglycemia are particularly dangerous in the older population. To reduce the risk of hypoglycemia, relaxation of the standard hemoglobin A 1c (HbA 1c ) goals has been proposed for frail elderly patients. However, the risk of hypoglycemia in this population with higher HbA 1c levels is unknown. Methods Patients 69 years or older with HbA 1C values of 8% or greater were evaluated with blinded continuous glucose monitoring for 3 days. Results Forty adults (mean [SD] age, 75 [5] years; HbA 1C value, 9.3% [1.3%]; diabetes duration, 22 [14] years; 28 patients [70%] with type 2 diabetes mellitus; and 37 [93%] using insulin) were evaluated. Twenty-six patients (65%) experienced 1 or more episodes of hypoglycemia (glucose level Conclusions Hypoglycemic episodes are common in older adults with poor glycemic control. Raising HbA 1C goals may not be adequate to prevent hypoglycemia in this population.