A 72-year-old woman with long-standing type 2 diabetes, mild cognitive impairment, and multiple comorbidities has an HbA1c of 6.3% on metformin and a ...

Question

A 72-year-old woman with long-standing type 2 diabetes, mild cognitive impairment, and multiple comorbidities has an HbA1c of 6.3% on metformin and a sulfonylurea. She reports several episodes of symptomatic hypoglycaemia. According to Canadian diabetes guidance, which HbA1c target and strategy are most appropriate?

Accepted Answer

Relax HbA1c target to around 7.5% to 8.0% and deprescribe the sulfonylurea

Answer

Maintain current therapy to keep HbA1c below 6.5%

Answer

Tighten glycaemic control further to achieve HbA1c below 6.0%

Answer

Stop metformin and continue sulfonylurea monotherapy to simplify dosing

Answer

Switch immediately to a basal-bolus insulin regimen targeting HbA1c 6.0% to 6.5%

ca-mccqe1 MCQ (SBA): Type 2 diabetes in older adults