Low Glycaemic States and the Risk of Frailty and Functional Decline in Older T2D Patients

Pavankumar Kamat


October 20, 2021


  • Low glycaemic states appear to increase the risk of frailty and functional decline in older patients with type 2 diabetes (T2D).

Why this matters

  • Findings highlight the role of hypoglycaemia as a risk factor for frailty in older patients with T2D, thereby warranting monitoring of glycaemic levels as an integral part of the management plans in these patients.

Study design

  • UK researchers performed a systematic review of 11 studies, identified through a literature search across Google Scholar, PubMed and Embase databases.

  • Funding: None.

Key results

  • Patients with hypoglycaemia had an increased risk of incident frailty (adjusted HR [aHR], 1.60; 95% CI, 1.14-2.42) in one study.

  • Patients with multiple (≥2) episodes of severe hypoglycaemia had an increased risk of fractures (aHR, 2.24; 95% CI, 1.56-3.21) in another study.

  • One study showed that hypoglycaemia was associated with a higher level of dependency (P<.001).

  • Two studies showed that mean admission blood glucose levels decreased with increasing frailty (P=.003) and HbA1c <6.9% was associated with an increased risk of frailty (aHR, 1.41; 95% CI, 1.12-1.78).


  • None of the studies in the review evaluated the direct association between hypoglycaemia and frailty.


Ah A, S P, Aj S. Low glycaemic state increases risk of frailty and functional decline in older people with type 2 diabetes mellitus - evidence from a systematic review. Diabetes Res Clin Pract. 2021 Oct 08 [Epub ahead of print]:109085. doi: 10.1016/j.diabres.2021.109085. PMID: 34634389  View abstract 

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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