Diabetes is a common health issue for older people living in Long Term Care homes in Canada with over 35% living with type 2 diabetes. In this population adherence to rigorous glycemic targets is poorly tolerated and associated with adverse events and higher mortality and is unlikely to provide benefit. These residents are at risk of hypoglycemia associated with falls, behavioural symptoms, cardiovascular complications and mortality. The approach to management of diabetes in older adults with frailty living in LTC homes should shift from prevention of long-term complications to the prevention of acute complications such as hypoglycemia.
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