Harm Of Overly Tight Control Of Blood Sugar Level

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

Further, autocratic 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 lousy health did not change in more than a decade, even though many had undergone years of aggressive blood sugar treatment antiaging. "There is increasing ground that tight blood sugar control can cause harm in older people, and older common people are more susceptible to hypoglycemia," said lead author Dr Kasia Lipska, an subordinate professor of endocrinology at Yale University School of Medicine.

So "More than half of these patients were being treated with medications that are uncongenial 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 velocity to manage diabetes in seniors alongside the other health problems they typically have, researchers said in horizon information with the study. For younger and healthier adults, the American Diabetes Association has recommended remedial programme that aims at a hemoglobin A1C consistent of lower than 7 percent, while the American Association of Clinical Endocrinologists recommends a target of trim 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 rely on to stave off the complications of diabetes, including organ damage, blindness, and amputations due to determination damage in the limbs. In this study, the authors analyzed 2001-2010 observations 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 lingering 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 continuously living. Overall, 61,5 percent of all these patients had achieved uncompromising blood glucose control. And a little more than half of them had done so by relying on drugs that can dramatically crop blood sugar levels. These include insulin and sulfonylureas, a medication that prompts the pancreas to start more insulin.

People with diabetes either don't produce insulin, a hormone needed to transfigure food into energy, or cells don't process it properly. Despite this aggressive treatment, the proportions of older diabetics in fantastic and poor health did not significantly change during the 10-year study period, occupation 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 deliberate over does dial into question the use of insulin or sulfonylureas to treat diabetes in older adults, but does not of course invalidate the goal of tight blood sugar control. "I pronounce it very interesting that the study shows that certain medications produce adverse outcomes, but concludes that the aim 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 distinguished outcomes with regards to hypoglycemia, should have been in use in patients at risk for hypoglycemia". However, both Garber and Lipska agreed that for older patients with diabetes, a "one-size-fits-all" diabetes care plan will not work.

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