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Surrey research finds that current guidelines for diabetes may be putting elderly patients at risk

Research undertaken at the University of Surrey’s Real-World Evidence Centre suggests that the current guidelines which recommend relaxing blood sugar control targets for elderly patients may be putting them at a higher risk of infection.

Currently, the diabetes guidelines provided by the National Institute for Health and Care Excellence (NICE) recommend that doctors consider relaxing the blood sugar control targets for elderly patients with diabetes who are less likely to experience the long-term benefits of a reduced risk of heart attacks and strokes.

However, the results of research conducted at the University of Surrey’s Real-World Evidence Centre, now suggests that older people with inferior control over their blood sugar levels are more likely to develop infections - a consequence which had not been discovered when the NICE diabetes guidelines were originally devised and distributed. 

The research involved performing a retrospective analysis of infection rates in older people (65 years and older) with diabetes. The researchers found that pneumonia, urinary tract infections, and skin and soft tissue infections were all more common in people with poor blood sugar control, whilst those with moderate blood sugar control did not appear to have an increased risk of infection.

As a result of this, older people with diabetes who relax their blood sugar control may be increasing their risk of contracting these infections.

“Preventing infections in older people with diabetes is vitally important as we know they are at a much higher risk than other people of developing complications and even dying from common infections. Our research suggests that when people have worse blood sugar control they are more likely to get these infections. This new finding should be taken into account by all clinicians when setting blood sugar targets in the elderly,” commented Lead Researcher Andrew McGovern, Clinical Researcher with the Department of Clinical and Experimental Medicine. He also went on to say that “further research is needed to identify the best balance between the risks of too strict blood sugar control and increased infection risk”.

The results of this research means that those responsible for selecting blood sugar control targets for older people will have to take into account the increased risk of infection when advising patients with diabetes.

These findings were also published online as the research publication 'Infection risk in elderly people with reduced glycaemic control' on The Lancet.

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