A growing body of research suggests that older adults with diabetes may need to adjust their blood sugar targets, as current standards designed for younger adults could pose risks to those over the age of 65.
Diabetes management typically relies on the A1c blood test, which tracks the average blood sugar levels over a three-month period. For most adults, a normal A1c level is below 5.7%, while levels between 5.7% and 6.4% indicate prediabetes. However, experts are now questioning whether these thresholds are suitable for older populations.
Recent studies, highlighted in publications like Fortune and The New York Times, have raised concerns that the standard blood sugar targets could be too strict for older adults, who may face unique health challenges. According to Dr. Sei Lee, a geriatrician at the University of California, San Francisco, older adults might have been misled by guidelines that advocate tight blood sugar control — a strategy that works well for younger individuals but may not be appropriate as people age.
Excessive blood sugar control in seniors could increase the risk of hypoglycemia (low blood sugar), which is more dangerous in this age group due to the higher likelihood of concurrent health issues. Severe hypoglycemia can lead to stroke, cognitive decline, falls, or even death.
The American Geriatrics Society advises older adults with diabetes to aim for an A1c range between 7.5% and 8%, while those with additional health concerns may safely target A1c levels as high as 9%. Despite the fact that these updated recommendations have been in place for over a decade, many older adults are still unaware of the change, especially if they have not seen a geriatric specialist who can offer tailored advice.
In a related study from last year, researchers found that individuals with prediabetes could significantly reduce their long-term risk of diabetes-related complications and death by delaying the onset of the condition through lifestyle changes such as diet and exercise.
As the aging population grows, these insights could reshape how diabetes is managed in older adults, potentially reducing unnecessary risks while improving overall quality of life.
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