Older adults being overtreated for diabetes

Aggressive treatment for diabetes is sometimes necessary, but in older adults this approach could lead to serious consequences.

A new study published in JAMA Internal Medicine found that many older patients with either type 1 or type 2 diabetes are being overtreated for the condition, which could result in dangerous episodes of hypoglycemia.

"In turn, hypoglycemia has been associated with poor outcomes, such as increased mortality, cardiovascular disease, falls and accidents, dementia, and low health-related quality of life," the authors wrote.

An individualized therapy approach

After examining the health records of 1,288 patients over 65 years old, the researchers found that 55 percent were treated with either insulin or sulfonylureas medications. But lowering blood sugar to a hemoglobin A1c below 7 percent could cause greater harm than good, said lead author Dr. Kasia Lipska, assistant professor of internal medicine at Yale School of Medicine.

For older adults with other health problems, the drop in blood sugar can lead to cardiovascular complications, confusion, coma or death.

The solution, therefore, may lie in a more individualized therapy approach, Lipska said.

"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."

Source: Yale University

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