Are people with diabetes getting medications that do more harm than good? Would they be better off with fewer medications? The American Geriatric Society and other experts agree that most adults over the age of 65 do not need to control their glucose levels as tightly as experts have previously recommended. Experts now agree that higher blood sugar (A1C) ranges between 7.5 and 9.0% should be considered instead of the previous goal of 7%. Other experts have suggested that insulin should be completely avoided in those over 80 if possible.
For example, a recent study found that use of the wrong insulin product (e.g. long-acting versus rapid-acting) and reduced food intake were two of the reasons that patients ended up going to the hospital with low blood sugar. For some older patients who are taking care of themselves without daily nursing help, a complicated treatment plan involving several drugs may be too difficult to follow correctly.
As a result of these new findings regarding low blood sugar, in 2013, the American Diabetes Association (ADA) and the European Association for the Study of Diabetes released updated recommendations calling for a more individualized approach to treatment, considering each patient’s health, preferences, support system (including meal planning abilities), risk of low blood sugar, cost, and other factors.