Tight glycaemic control is associated with a significant reduction in serious long-term diabetes-related complications, but there needs to be some flexibility, as certain conditions, such as illness and infections can raise blood glucose levels as more glucose is released into the blood stream to help fight the infection.12,17,18

NICE recommends relaxing HbA1c targets on a case-by-case basis for certain groups of people, and particularly for those who are older or frail:12

·       who are unlikely to achieve longer-term risk-reduction benefits, for example, people with a reduced life expectancy;

·       for whom tight blood glucose control poses a high risk of the consequences of hypoglycaemia (eg those at risk of falling, those with an impaired awareness of hypoglycaemia, and people who drive or operate machinery);

·       for whom intensive management would not be appropriate, such as people with significant comorbidities.