a b s t r a c tGeriatric frailty has drawn growing interest in recent years for its associations with multiple adverse outcomes. Previous studies showed that interventions may improve some aspects of frailty such as physical function. However, interventions targeting the entire frailty construct have not been systemically reviewed. We conducted a comprehensive search for randomized controlled trials targeting geriatric frailty. Only trials that measured outcomes based on their predefined frailty indicators were included. Of 98 articles, 11 met the inclusion criteria. Eight studies were classified as high quality. Of the six exercise-based interventions, five showed significant improvements on at least two of their frailty indicators. Hormone replacement therapy was not effective. Two of the three multifactorial interventions have not published their results, and the third did not show significant improvements. More studies with standardized definitions and measurements of frailty are needed to determine the effectiveness of interventions on geriatric frailty.

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Hypoglycemia due to underlying terminal illness in nondiabetic end-of-life patients receiving palliative care has not been fully studied. For example, we do not have adequate information on the frequency of spontaneous hypoglycemia in patients as occurs during the different stages of palliative care. Depending on the case-mix nature of the palliative care ward, at least 2% of palliative care patients may develop hypoglycemia near the end of life when the remaining life expectancy counts down in days. As many as 25%–60% of these patients will neither have autonomic response nor have neuroglycopenic symptoms during a hypoglycemic episode. Although it is not difficult to diagnose and confirm a true hypoglycemia when it is suspected clinically, an episode of hypoglycemic attack may go unnoticed in some patients in a hospice setting. Current trends in palliative care focus on providing treatments based on a prognosis-based framework, involving shared decision-making between the patient and caregivers, after considering the prognosis, professional recommendations, patient’s autonomy, family expectations, and the current methods for treating the patient’s physical symptoms and existential suffering. This paper provides professional care teams with both moral and literature support for providing care to nondiabetic patients presenting with hypoglycemia.