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Research Letter
July 2016

Simplification of Insulin Regimen in Older Adults and Risk of Hypoglycemia

Author Affiliations
  • 1Joslin Diabetes Center, Boston, Massachusetts
  • 2Beth Israel Deaconess Medical Center, Boston, Massachusetts
  • 3Department of Medicine, Harvard Medical School, Boston, Massachusetts
  • 4School of Pharmacy, MCPHS University, Boston, Massachusetts
JAMA Intern Med. 2016;176(7):1023-1025. doi:10.1001/jamainternmed.2016.2288

Hypoglycemia is a serious adverse event, especially in older patients with diabetes, and is associated with poor outcomes.1 Intensive insulin regimens add a large burden of self-care to older patients and increase the risk of hypoglycemia.2,3 Treatment guidelines and expert consensus recommend deintensification of treatment regimens in older adults.4 However, the effect of insulin regimen simplification on the risk of hypoglycemia or uncontrolled hyperglycemia is not known. In addition, the lack of an algorithm to guide insulin regimen simplification may account for missed opportunities to deintensify insulin regimens in older patients with diabetes.5

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