Frailty, manifesting in weight loss and malnutrition, leading to decreased hyperglycemia and normalization of blood glucose levels, may develop in older diabetics. This in turn leads to an increased risk of hypoglycemia. Current guidelines suggest relaxed glycemic control in diabetic, frail elderly patients.
A British study reviewing the impact of frailty on blood glucose level normalization has suggested not simply a more relaxed glycemic control in frail elderly with diabetes, but that complete withdrawal of hypoglycemic medications may be necessary. The researchers recommend that doctors regularly review medications taken in this vulnerable population “with consideration of gradual reduction or complete withdrawal when frailty and significant weight loss emerge”.
The review is available free to read here: http://www.future-science.com/doi/full/10.4155/fsoa-2015-0016.