Is Less-Intensive Glycemic Control in Older Adults Associated with Risk for Serious Infection?

Clinical guidelines recommend against tight glycemic control for most older adults with type 2 diabetes (Diabetes Care 2025; 48[Suppl 1]:S266). One concern with less-intensive treatment is infection; poor control (i.e., glycosylated hemoglobin [HbA_1c] >9%) increases infection risk. Researchers performed a retrospective study in 103,000 older patients (age, ≥65) to examine whether an intermediate HbA_1c target (i.e., 7%–9%) is associated with excess infections (respiratory; genitourinary; skin, soft tissue, and bone; and sepsis). Patients were stratified by baseline glycemic control: HbA_1c of 8% to 9%, 7% to 8%, or “intensive control” (6%–7%).

A total of 3.6% of patients were hospitalized with infections during 12 months of follow-up. After ad…