Doctors May Overtreat Older Adults for Diabetes
Maintaining a regular blood sugar level is a critical part of diabetic patient health. But a study published in the JAMA: Internal Medicine found that many older adults are overtreated.
The American Diabetes Association suggests controlling blood sugar on a daily basis to achieve an overall hemoglobin A1C level of less than 7 percent, while the Association of Clinical Endocrinologists recommends a level below 6.5 percent. For most young patients, this means dietary and lifestyle changes supplemented with regular blood sugar testing and insulin supplemented as needed. For older adults who often suffer from other disabling and chronic conditions, controlling blood sugar can become more complicated.
Hypoglycemia is the leading cause of diabetic complications in older adults and accounts for nearly one in four emergency hospitalizations related to adverse drug events. An analysis of 1,288 older adults diagnosed with diabetes found that 61.5 percent had a tight glycemic control. With almost two-thirds of diabetic older adults with poor health attaining tight glycemic control, the authors conclude, “These vulnerable adults are unlikely to experience the benefits of intensive glycemic control…” Instead, they note, they may suffer adverse events like hypoglycemia.
Researchers suggest that older adults with other chronic health conditions may benefit from less emphasis on tight glycemic control and better focus on overall health.
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