Simplified Insulin Protocol Using Lantus in Elderly
Simplified Insulin Protocol Using Lantus in Elderly
The purpose of this study is to find out if simplifying your diabetes treatment by decreasing
 number of insulin injections, with the help of a long acting insulin called glargine, can
 decrease the episodes of low blood glucose.
As patients with diabetes age, adverse social and medical problems may arise. Because of
 these problems patients, even those managing their diabetes for many years, find it difficult
 to continue with complicated insulin schedules. This may lead to errors in treatment and poor
 glucose control. Simplification of treatment has been found to the decrease risk of low blood
 glucose, a very dangerous condition at this age. In a previous study, the investigators found
 that simplifying treatment did not cause the blood sugars to rise out of control. In this
 study, the investigators plan to simplify insulin treatment and monitor for low glucose
 episodes with help of a continuous glucose monitor and A1C (measure of average glucose
 control over 3 months). The investigators will simplify the treatment by adding glucose
 lowering medications that you can take by mouth, in addition to the injection of long acting
 insulin called glargine.
Inclusion Criteria:

 -  Age 70 years or older

 -  Diagnosis of diabetes mellitus Type II

 -  At least 2 (short-acting or mixed) insulin injections per day

 -  At least 1 episode of hypoglycemia (glucose value <70) on screening CGM

 Exclusion Criteria:

 -  Patients with the following illnesses in the past 12 months Myocardial infarction
 Angina Coronary artery bypass grafting Percutaneous transluminal coronary angiography
 Cerebrovascular event (stroke, TIA)

 -  Active liver disease (history of cirrhosis or LFT > 3 times normal)

 -  On dialysis or with severe renal dysfunction (creatinine clearance <20 ml/min)

 -  Malignancy that limits life span to less than 18 months

 -  Patients seen in the geriatric clinic who already have simplified regimen as proposed
 in the study