Diabetes is a chronic (long-lasting) disease that affects how your body turns food into energy. There are three main types of diabetes: type 1, type 2, and gestational diabetes (diabetes while pregnant).
More than 122 million Americans are living with diabetes (37.3 million) or prediabetes (96 million).
In a recent study from the University of Michigan, scientists found that more doctors and such patients should work together to dial back diabetes treatment when necessary.
Doctors often treat diabetes with an eye toward long-term effects, but the team suggests that effective treatment requires a personalized approach based on individual risk and benefit.
In the study, researchers examined detailed records from 78,792 Medicare participants with diabetes who were 65 and older and lived in 10 states.
Almost 11 percent had very low ongoing blood sugar levels recorded during the study period, suggesting overtreatment.
But only 14 percent of that subgroup had a reduction in blood sugar medication refills in the six months after that reading.
The team found patients 75 and older, as well as those who qualified for both Medicare and Medicaid because of low income or serious disability, were most likely to be overtreated.
Patients over 75 were less likely than others to have their treatment dialed back, as measured by prescription doses and refills.
But patients who had more than six chronic conditions, or who lived in urban areas or had frequent outpatient visits, were more likely to have their medication dialed back.
The researchers warn against a one-size-fits-all approach to treating diabetes in older patients.
Instead, they advise greater personalized care that accounts for the risks and benefits that such treatment holds for each patient.
The team says that older patients with diabetes — and the adult children who often assist with their care —should talk to their care teams about whether de-intensification is right for them.
It can be hard for an older person to recognize the signs of too-low blood sugar, such as confusion and combativeness, or of too-low blood pressure, such as dizziness.
Elderly patients can also struggle to keep up with multiple medications and frequent blood sugar checks. De-intensifying their treatment can often provide relief.
If you care about diabetes, please read studies that eating more eggs linked to higher risk of type 2 diabetes, and how to eat to reduce heart disease death risk if you have diabetes.
For more information about nutrition, please see recent studies about high-protein diet linked to higher risk of type 2 diabetes, and results showing Mediterranean diet could help reduce the diabetes risk by 30%.
The study was published in the Journal of General Internal Medicine and conducted by Jeremy Sussman et al.
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