Question

An 82-year-old frail woman with long-standing type 2 diabetes lives in a nursing home. She has moderate dementia and a history of falls. She is on basal-bolus insulin with an HbA1c of 6.4%. She has had two episodes of symptomatic hypoglycaemia in the past month. According to Canadian guidance for older people with diabetes, what is the most appropriate glycaemic management strategy?

Accepted Answer

Relax glycaemic targets and de-intensify therapy to reduce hypoglycaemia risk, aiming for an HbA1c around 7.1-8.5%.

Answer

Maintain current intensive insulin regimen to keep HbA1c <7%.

Answer

Tighten glycaemic control further to HbA1c <6.0% to prevent complications.

Answer

Stop all diabetes medications immediately.

Answer

Switch to high-dose sulfonylurea to simplify the regimen.

Practice question