Diabetes guidelines for doctors (such as those by NICE) suggest that they consider relaxing the blood sugar control targets for older people. This is because older people are less likely to get the long-term benefits of improved blood sugar control such as reduced risk of heart attacks and stroke.

However, our latest research demonstrates that older people with worse blood sugar control are at increased risk of developing infections. This was not known when these guidelines were devised and should now be taken into account when considering relaxing blood sugar control. We show that people with poor blood sugar control are more likely to catch pneumonia, get urinary tract infections, and get infections of the skin (cellulitis) than people with good control.

Previously we knew that people with diabetes are at higher risk of contracting common infections than people without diabetes. We also knew that they are also at a higher risk of getting complications and dying from these infections. Our study adds data which suggest that relaxing blood sugar control in older people may increase the risk of infection and infection complications. We suggest that people responsible for selecting blood sugar control targets for older people take into account these increased infection risks.

Dr Andrew McGovern
University of Surrey-Lilly Real World Evidence Centre
Department of Clinical and Experimental Medicine, University of Surrey
Guildford, UK

Publication

Infection risk in elderly people with reduced glycaemic control.
McGovern A, Hine J, de Lusignan S.
Lancet Diabetes Endocrinol. 2016 Apr

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