title: [How to prevent severe hypoglycemia in older patients with type 2 diabetes].
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.
authors.affiliation: Service d'endocrinologie, diabétologie et nutrition, HUG, 1211 Genève 14. Bettina.Kohler@hcuge.ch
authors.forename: B
authors.initials: B
authors.lastname: Köhler Ballan
authors.forename: C
authors.initials: C
authors.lastname: Tran
authors.forename: L
authors.initials: L
authors.lastname: Perrenoud
authors.forename: U M
authors.initials: UM
authors.lastname: Vischer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology / Q000517:prevention & control*; D012307:Risk Factors