For patients with advanced diabetes
complications, life-limiting comorbid illness,
or substantial cognitive or functional
impairment, it is reasonable to
set less intensive glycemic target goals.
These patients are less likely to benefit
from reducing the risk of microvascular
complications and more likely to suffer
serious adverse effects from hypoglycemia.
However, patients with poorly controlled
diabetes may be subject to acute
complications of diabetes, including
dehydration, poor wound healing, and
hyperglycemic hyperosmolar coma.
Glycemic goals at a minimum should
avoid these consequences.