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Updated: May 26, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
[How to prevent severe hypoglycemia in older patients with type 2 diabetes]
B Köhler Ballan1, C Tran, L Perrenoud
1Service d'endocrinologie, diabétologie et nutrition, HUG, 1211 Genève 14. Bettina.Kohler@hcuge.ch
Abstract:
Severe hypoglycemia is a feared complication of treatment in older diabetic patients (> 75 years) and a limiting factor for good glycemic control. Its real incidence is not well studied and probably underestimated. Cognitive impairment, malnutrition and/or cachexia, polypharmacy and a recent hospitalization are risk factors for severe hypoglycemia specific for older patients. Cognitive impairment screening can identify patients unable to manage their treatment. Simplification of treatment and/or transferring its execution to relatives must then be considered. Prevention also involves the detection of malnutrition and comorbidities, Age-adjusted therapeutic targets (HbA1c 7-8%) are important to avoid an exceedingly strict glycemic control. However, giving up on good glycemic control is not an adequate prevention strategy in itself.
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