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About a third of Americans over age 65 have diabetes; last month, the Endocrine Society unveiled new guidelines for their treatment.

Its recommendations included higher glucose and A1c targets for older people with diabetes, particularly those with several other chronic illnesses and cognitive impairment, or those having difficulty handling daily activities.

...

In recent years, a number of medical groups have advocated more moderate blood sugar targets for older patients, including the American Geriatrics Society, the American College of Physicians, the American Diabetes Association and the Veterans Affairs medical system.

Having the Endocrine Society also weigh in — its membership includes most endocrinologists treating patients in the United States — may help spread the word.

...

...the Endocrine Society guidelines and others recommend lower blood glucose levels and hemoglobin A1c ranges for older adults in good health, but higher targets for those with other illnesses and limited life expectancies. They likely won’t survive long enough to benefit from strict glycemic control; in the meantime, it could hurt them.

The Endocrine Society suggests an A1c from 7 to 7.5 percent for the healthiest older people, depending on whether they’re taking drugs that can cause hypoglycemia. The ranges increase to 7.5 to 8 percent for those with several chronic illnesses or with early dementia and other impairments, and to 8 to 8.5 percent for those in poor health.

The last category includes those with end-stage diseases or moderate to severe dementia, as well as nursing home residents.


https://www.nytimes.com/2019/04/12/health/elderly-diabetes-a...
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