New research suggests diabetes may be overtreated in many older adults in the U.S.
Recent findings suggest older adults with diabetes and complex-intermediate to complex-poor heath statuses still maintained tight blood sugar control, which suggests the condition is being overtreated because insulin and sulfonylureas treatment can lead to low blood sugar, the JAMA Network Journals reported.
Older adults may derive less benefit from intensive blood sugar control and may be more susceptible to hypoglycemia, which can be a serious threat to this age group.
To make their findings the researchers looked at data on 1,288 adults (65 years and over) with diabetes from the National Health and Nutrition Examination Survey (NHANES) from 2001 through 2010. The patients were divided into three groups based on health status:: very complex-poor; complex-intermediate; and relatively healthy. Tight glycemic control was classified as an HbA1c level less than 7 percent.
Of the 1,288 older adults with diabetes, 50.7 percent were relatively healthy, 28.1 percent had complex-intermediate health and 21.2 percent had very complex-poor health. A total of 61.5 percent of the adults had an HbA1c level less than 7 percent across all categories and 54.9 percent of the participants were treated with either insulin or sulfonylureas.
"Using a nationally representative sample of U.S. adults, we showed that nearly two-thirds of older adults with diabetes who have complex/intermediate or very complex/poor health attained tight glycemic control. These vulnerable adults are unlikely to experience the benefits of intensive glycemic control and instead are likely to experience harms from treatment, such as hypoglycemia and other adverse effects. Recognition of both the harms and benefits of glycemic control is critical for patients and physicians and other health care professionals to make informed decisions about glucose-lowering treatment," the study concludes.
The findings were published in a recent edition of the journal JAMA Internal Medicine.
