Intensive glucose-lowering therapy might harm older adults with type 2 diabetes

Intensive glucose-lowering therapy might harm older adults with type 2 diabetes

A new study suggests more than 25% of adults with type 2 diabetes received intensive glucose-lowering therapy.

This includes 18.7% who were at risk for treatment-related adverse effects because of advanced age and co-existing illnesses, according to a new study published online by JAMA Internal Medicine.

Clinical guidelines recommend a target hemoglobin A1c level less than 7.0% for most nonpregnant adults with type 2 diabetes.

Patients with advanced age, a limited life expectancy and complex health problems likely will not benefit from tight glycemic control and could actually be harmed.

Researchers used an administrative claims data in their study of 31,542 adults to examine the association and frequency of intensive glucose-lowering treatment and severe hypoglycemia (abnormally low blood glucose) in adults with type 2 diabetes who were not using insulin.

In total, 8,048 (25.5%) patients were treated intensively, including 7,317 patients (26.5%) with low clinical complexity and 731 patients (18.7%) with high clinical complexity.

The intensive treatment of patients with high clinical complexity because of age (75 or older), other medical conditions, or both, increased the incidence of severe hypoglycemia from 1.7% to 3%, according to the results.

“Individualized assessment of clinical complexity, in addition to careful consideration of likely risks and benefits of intensive glucose-lowering therapy, is therefore an important part of patient-centered diabetes management,” the authors conclude.

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News source: The JAMA Network. The content is edited for length and style purposes.
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