Visit after visit, Dr. Pei Chen hoped to persuade a patient with Type 2 diabetes to allow her blood sugar levels to rise. Yes, rise.

The woman, who was 84 when she first came to the geriatric clinic at the University of California, San Francisco, had been coping with the disease for decades, following a complex regimen of frequent finger sticks and daily injections involving two types of insulin.

Geriatricians often encourage older and frailer patients with diabetes to ease up on efforts to achieve very low blood sugar levels (an approach called “de-intensification”), pointing out that the balance between benefits and risks shifts with age and illness.

You might think those patients would be delighted to take less medication and maybe enjoy the occasional cookie. But older people with diabetes often have long histories of striving to keep their hemoglobin A1c levels (a two- or three-month average measuring blood sugar control) below the once-standard 7 percent.