Author Affiliations: Frank Knox Fellow, Harvard University, Cambridge, Massachusetts.
In their assessment of hypoglycemia among elderly patients,1 the authors fail to account for impaired renal function, which is increasingly likely to occur in patients with long-standing diabetes, particularly those with concomitant cardiovascular risk factors.2 This is of particular pertinence to patients taking insulin, sulfonylureas, and glitazones.3 When assessing dosage and suitability of agents for diabetic control in elderly patients, physicians must account for renal function in addition to hemoglobin A1c goals to avert the potentially devastating sequelae of hypoglycemia.
Ali AM. Hypoglycemia Associated With Impaired Renal Function. Arch Intern Med. 2011;171(16):1512. doi:10.1001/archinternmed.2011.378