Harm Of Overly Tight Control Of Blood Sugar Level

Harm Of Overly Tight Control Of Blood Sugar Level.
Many older occupy with diabetes may be exposed to unrealized harm because doctors are trying to smother overly tight control of their blood sugar levels, a new study argues. Researchers found that nearly two-thirds of older diabetics who are in unfortunate health have been placed on a diabetes management regimen that strictly controls their blood sugar, aiming at a targeted hemoglobin A1C neck and neck of less than 7 percent. But these patients are achieving that ideal through the use of medications that place them at greater risk of hypoglycemia, a retaliation to overly low blood sugar that can cause abnormal heart rhythms, and dizziness or loss of consciousness, the researchers said.

Further, under the influence diabetes control did not appear to benefit the patients, the researchers report Jan 12, 2015 in JAMA Internal Medicine. The proportion of seniors with diabetes in in reduced circumstances health did not change in more than a decade, even though many had undergone years of aggressive blood sugar treatment. "There is increasing basis that tight blood sugar control can cause harm in older people, and older clan are more susceptible to hypoglycemia," said lead author Dr Kasia Lipska, an auxiliary professor of endocrinology at Yale University School of Medicine.

So "More than half of these patients were being treated with medications that are implausible to benefit them and can cause problems". Diabetes is common among people 65 and older. But doctors have struggled to come up with the best modus vivendi to manage diabetes in seniors alongside the other health problems they typically have, researchers said in upbringing information with the study. For younger and healthier adults, the American Diabetes Association has recommended remedial programme that aims at a hemoglobin A1C wreck of lower than 7 percent, while the American Association of Clinical Endocrinologists recommends a target of condescend than 6,5 percent, the authors noted.

The A1C test provides a picture of your average blood sugar levels for the erstwhile two to three months. By tightly controlling blood sugar levels, doctors trust to stave off the complications of diabetes, including organ damage, blindness, and amputations due to courage damage in the limbs. In this study, the authors analyzed 2001-2010 details on 1,288 diabetes patients 65 and older from a US survey. The patients were divided into three groups based on their well-being status: About half were considered comparatively healthy despite their diabetes; 28 percent had complex/intermediate health, in that they also suffered from three or more other lasting conditions or had difficulty performing some basic daily activities.

Roughly 21 percent had very complex/poor health, and were either dependent on dialysis or struggling with activities of regular living. Overall, 61,5 percent of all these patients had achieved mingy blood glucose control. And a little more than half of them had done so by relying on drugs that can dramatically humble blood sugar levels. These include insulin and sulfonylureas, a medication that prompts the pancreas to stage more insulin.

People with diabetes either don't produce insulin, a hormone needed to switch food into energy, or cells don't process it properly. Despite this aggressive treatment, the proportions of older diabetics in approving and poor health did not significantly change during the 10-year study period, profession into question whether doctors are overtreating these patients to no real benefit "I don't fantasize we should be using insulin or sulfonylureas in older patients.

This study shows that with people in poorer health, we're treating them aggressively with these drugs, and it makes no difference". Dr Alan Garber, of the Baylor College of Medicine in Houston, said the research does summons into question the use of insulin or sulfonylureas to treat diabetes in older adults, but does not irresistibly invalidate the goal of tight blood sugar control. "I set aside it very interesting that the study shows that certain medications produce adverse outcomes, but concludes that the ambition of treatment is the problem and not the medication," said Garber, a professor of diabetes, endocrinology and metabolism.

So "An equally valid conclusion is that it shows that many of the newer medications, which have been proven in multiple trials to have supreme outcomes with regards to hypoglycemia, should have been hand-me-down in patients at risk for hypoglycemia". However, both Garber and Lipska agreed that for older patients with diabetes, a "one-size-fits-all" diabetes therapy plan will not work.

And "We have need of to individualize diabetes management, including the goals. For some individuals, the time-honoured goals are perhaps too low for their ability to tolerate it. On the other hand, you have to try them on medications with a blue risk of hypoglycemia". Lipska said she would "encourage people to talk with their physicians and to seek to understand better what are the potential benefits and what are the risks of treatment keepskinclear.com. There isn't one universal goal for everyone".