Are Some Diabetes Treatments Going Too Far?

The management of older adults with type 2 diabetes requires careful consideration of the effects that advancing age and changes in health status can have on the competing risks and benefits of therapeutic interventions. Physicians may vary in their approaches, which may be influenced by past patient experience or simply ot of the book medical training. A new study hints that some of the traditional practices may be harmarmful. 

NEW HAVEN — ONE of my elderly patients has Type 2 diabetes and heart disease. He takes a number of medications, including insulin to control his blood sugar levels. A few years ago, he was driving when his blood sugar suddenly dropped. He felt lightheaded for a moment, and then ran into a tree.

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Many older people with diabetes who have other health problems have been kept on intensive and potentially harmful blood sugar control regimens, according to the paper published Monday in JAMAInternal Medicine.

Diabetes is common in people 65 and older. However, it is questionable how much benefit they get from being kept on drugs that tightly control their blood sugar, the research found.

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A substantial proportion of elderly adults with diabetes and in poor health are being treated to tight glycemic targets with insulin or sulfonylureas, potentially placing them at increased risk for severe hypoglycemia, a new study reveals.

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American doctors may be giving drugs to a lot of older diabetic patients who are unlikely to benefit and might even be harmed, a new study in JAMA Internal Medicine suggests. Older, sicker patients are treated as aggressively to get their blood sugar under control as healthier patients are, according to an analysis of a nationally representative survey of Americans 65 and older. That’s despite what researchers say is greater risk that they’ll suffer from dangerously low blood sugar, known as hypoglycemia, and little evidence that they benefit from intense diabetes management.

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photo credit Flickr/DIPB Images https://www.flickr.com/photos/diacimages/5774894486/

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