Older diabetics striving for a higher A1C? Older patients with multiple medical conditions might see their blood sugar levels drop to a dangerously low point when taking different medications for different health problems, so the usual aggressive control of those low A1c numbers might do more harm than good by causing hypoglycemia (low blood sugar levels), which can lead to confusion, coma, and even death.
Diabetes treatment is important and has saved many lives, but in older patients with multiple medical conditions too much treatment could cause harm.
A study was published in JAMA Internal Medicine that found that many older diabetes patients were given aggressive treatment for their diabetes regardless of their health status and blood sugar levels. In patients 65 and older, this could pose a problem for their health.
According to Dr. Kasia Lipska, Assistant Professor of Internal Medicine at Yale School of Medicine: “We treat diabetes to prevent complications of the disease by lowering blood sugar levels, but the problem with aggressively lowering blood sugars in older people – to a hemoglobin A1c below 7% — is that it is uncertain whether this approach provides a benefit, and it could, in fact, cause greater harm.” Continuing, Dr. Lipska added, “Our study suggests that we have a one-size-fits-all approach despite questionable benefits and known risks. We have been potentially over-treating a substantial proportion of the population.”
Dr. Lipska also stated, “We should use an individualized therapy approach when treating older diabetes patients. Older patients who are relatively healthy may benefit if they are treated in a similar way to younger diabetes patients, but this approach might not work in older patients who often have other health issues.”