Abdelhafiz AH, Peters S, Sinclair AJ, et al. - Among older people with type 2 diabetes, an increased risk of frailty and functional decline was found in relation to the presence of low glycaemia. In these patients, management should minimize low glycaemia incidence.

• This is a systematic review of 11 studies, with six studies assessing risk of frailty or physical decline with hypoglycemia.

• An increased risk of incident frailty (HR 1.60) in one study and risk of fractures in four studies (2.24, 1.24, 1.94, and 1.71, respectively) was attributed to hypoglycemia.

• Hypoglycemia linked with dependency in the sixth study.

• Five studies investigated the relation of low blood glucose/HbA1c to frailty.

• One study revealed that mean blood glucose reduced with increasing frailty.

• An inverse correlation of HbA1c with clinical frailty scale and increase in frailty risk due to HbA1c<6.9%, respectively, were the findings in two studies.

• In the last two studies, HbA1c <6.5% related to risk of any fracture (HR 1.08) and HbA1c <6.0% linked with elevated risk of care need (3.45) respectively.