In a study published in the NEJM, Warfarin, Insulin, anti-platelet agents and Oral diabetic medications were alone or in combination responsible for 67% of adverse drug reaction related hospitalizations among the elderly in the US. I don’t think its any different in the UK. Striving for tight glycemic control in the elderly is counterproductive as evidence by the above study. In most elderly symptom control and a sensible individualized glycemic target is essential. Primum non nocere.