Are Older Adults Being Overtreated for Diabetes?
Older patients are not the same as younger patients. You’d think this was obvious, yet doctors often use a one-size-fits-all approach to prescribing treatment that can put their older patients at risk.
The latest example of this: another study showing that patients 65 or older with diabetes may be overtreated by doctors who too aggressively try to control blood sugar levels, regardless of their patients’ other health problems.
The new study, by Yale researchers, analyzed a decade of data on 1,288 diabetes patients age 65-plus, from a federal health survey. Although the patients ranged from being relatively healthy to being in poor health with multiple problems, there was little difference in the proportion given insulin and sulfonylurea drugs to tamp down their blood sugar to the same low level.
This can put older patients at risk for hypoglycemia — a dangerous reaction to low blood sugar that can cause confusion, rapid heartbeat, vision problems and loss of consciousness, according to lead study author Kasia Lipska, M.D., assistant professor of endocrinology at the Yale School of Medicine.
There’s also little evidence that aggressively lowering blood sugars in older people to the standard target — hemoglobin A1C below 7 percent — provides any benefit, “and it could, in fact, cause greater harm,” she said in a statement.
“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,” Lipska said. The study was published Jan. 12 Continue reading