In frail older adults with diabetes, A1C goals may be relaxed to which range?

• A. 8.0% or 8.5%
• B. 6.0% or 6.5%
• C. 7.0% or 7.5%
• D. 9.0% or 9.5%

Answer: (A)

In frail older adults with diabetes, the goal is to reduce the risk of hypoglycemia and preserve function, rather than pursue tight glucose control. Because these individuals have higher vulnerability to low blood sugars, multiple comorbidities, and often limited life expectancy, A1C targets are relaxed.

The typical relaxed range is about 8.0% to 8.5%. This balances avoiding the dangers of hypoglycemia with the realities of frailty and polypharmacy, aiming for safer overall management and quality of life. Targets much tighter, like around 6% or 6.5%, increase hypoglycemia risk and may not provide meaningful benefit in this group, while targets that are too high, such as 9% or above, can leave hyperglycemia-related complications unaddressed in someone with limited remaining life expectancy.