A 72 year old woman in a long term care facility has a history of recurrent falls and mild cognitive impairment. She has type 2 diabetes managed with ...

Question

A 72 year old woman in a long term care facility has a history of recurrent falls and mild cognitive impairment. She has type 2 diabetes managed with basal bolus insulin and metformin. Her HbA1c is 6.3% and she has had two episodes of symptomatic hypoglycaemia in the last month. According to Diabetes Canada, what is the most appropriate glycaemic target and management strategy?

Accepted Answer

Relax target HbA1c to approximately 7.5-8.0% and de-intensify insulin

Answer

Maintain current regimen and target HbA1c below 6.5%

Answer

Intensify insulin to target HbA1c below 6.0%

Answer

Stop all diabetes medications

Answer

Aim for random capillary glucose below 4.0 mmol/L

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