The challenge of managing type 2 diabetes in the older patient

Key points  Diagnosis of diabetes in the older patient is often missed or delayed because symptoms like confusion, dizziness, nocturia are common and are often non-specific. Though strict glycaemic control reduces the risk of death and diabetes-related complications, it poses a greater risk of life-threatening hypoglycaemia in the elderly.  Sulfonylureas increase risk of life threatening hypoglycaemia in elderly. Those who are at high risk of malnutrition should have unrestricted meal and food; the medications should be adjusted as needed to manage diabetes.  Assessment of frailty, consideration of polypharmacy, comorbidity, carer education, multidisciplinary care are key aspects of management. CPD credits: 0.5.