Management of type 2 diabetes in very old patients according to glycemic control and health status.

Abstract

The prevalence of diabetes in the elderly is increasing worldwide with more than a third of patients aged 75 years or older having diabetes.1,2 T he great heterogeneity in the health status of older patients with type 2 diabetes (T2D) makes an assessment beyond glycemia or glycated hemoglobin A1c (HbA1c ) necessary.3 Current guidelines and several studies support the claim that factors such as the presence of comorbidities, dementia, depression, functional dependence, frailty, or polypharmacy must be taken into account when establishing glycemic targets for elderly patients.3-6 In recent years, several reports have highlighted that elderly patients with a complex health status managed with tight glycemic control and intensive antidiabetic therapy are more likely to be harmed, particularly because of drug -induced hypoglycemia.