Some older adults overtreated for diabetes
For some diabetes patients over the age of 65, keeping a rigorous control of their blood sugar levels may actually cause harm. A new study published in the JAMA Internal Medicine found that older people with diabetes are more likely to experience hypoglycemia—low blood sugar—compared to younger patients. Hypoglycemia can have serious consequences for the body and lead to hospitalization or even death.
The American Diabetes Association (ADA) recommends that people with diabetes maintain a hemoglobin A1c level of less than seven percent. Hemoglobin A1c is a measurement of a patient’s average glucose level over extended periods of time.
Researchers from the Yale School of Medicine analyzed data from the National Health and Nutrition Examination Survey (NHANES). They looked at 1,288 adults over the age of 65 from 2001 to 2010. The participants, who were all known diabetes patients, were split into three groups: People who were relatively healthy (50.7 percent), people with complex health who may need someone to help take care of them (28.1 percent), and people with significant impairment and illness who may have a limited life expectancy (21.2 percent).
Overall, 61.5 percent of participants across all three groups had a hemoglobin A1c of less than seven percent. Additionally, 54.9 percent of participants across all three groups treated their diabetes with insulin or sulfonylureas.
The study noted that older patients with intermediate, complex or poor health may see more harm than good by maintaining such tight glycemic control. Some study limitations included other conditions the participants had that may have made them more prone to hypoglycemia.
The researchers did acknowledge that the ADA recently raised its recommended glucose target levels for older patients.