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Diabetes in frailty — SCE Endocrinology MCQ

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EasyDiabetesDiabetes in frailtySCE Endocrinology

A 74-year-old woman with type 2 diabetes is in a care home. HbA1c is 44 mmol/mol on insulin degludec 40 units daily and gliclazide. She has dementia and two falls after morning confusion. What is the most appropriate management?

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Correct answer: D — De-intensify hypoglycaemia-causing therapy and set a relaxed glycaemic target

In frailty and dementia, tight glycaemic control with insulin and sulfonylurea exposure can be harmful. De-intensification and a safer individualised target reduce hypoglycaemia and falls. HbA1c targets should reflect benefit horizon and treatment burden.

Reference: NICE NG28; JBDS Frailty Guidance