When it comes to hospice patients with type 2 diabetes, avoiding hypoglycemia may be more important than strict glycemic control, researchers argued.
As for severe hypoglycemia -- a glucose reading under 50 mg/dL -- this was experienced by approximately 5% of hospice patients in nursing homes within 180 days of admission, reported Laura A. Petrillo, MD, of Massachusetts General Hospital in Boston, and colleagues.
The risk was even greater for those receiving insulin: cumulative incidence of 38% for all hypoglycemia and 18% for severe episodes within 180 days of admission, with the peak risk occurring during the initial 20 days. Hyperglycemia incidence was 9% overall; 35% among those on insulin.
"[H]ypoglycemia is not consistent with a goal of comfort, and these data demonstrate suboptimal avoidance of dysglycemia among patients with type 2 diabetes on hospice in nursing homes," wrote Petrillo and colleagues.