A new study in the Journal of General Internal Medicine suggests doctors and patients in Medicare should work together to dial back treatment in older adults, some of whom have been found to have too-low blood sugar levels.
The study found that nearly 11% of Medicare participants had very low blood sugar levels. But only 14% of those had a reduction in blood sugar medication prescription refills over the next 6 months. In other words, not much was being done about modifying their treatment plan.
This can be risky, as those over 70 having too-low blood sugar can raise the risks of dizziness, confusion, falling, and death. Signs of blood sugar that is too low can be confusion or combativeness, and signs of blood pressure that is too low can be dizziness. Reducing treatment in older patients can be a relief, as they will not have to deal with so many daily medications and blood sugar checks.
Despite these findings, older patients with low blood sugar seem to still receive the same levels of treatment. It is a balancing act to try to get the right level of medication for any diabetes patient. “By focusing on both overtreatment and undertreatment ends of the diabetes quality spectrum, we can begin to improve the quality of diabetes care in all respects, ensuring that patients get needed care while avoiding unnecessary potential harm,” said Jeremy Sussman, M.D., M.S., a coauthor of the study.
By the time a patient is in his or her 70s, he or she has most likely already received the benefits of long-term tight glycemic control. So doctors should pay more attention to individualizing diabetes treatment for each person, especially older populations who might also have other conditions that they are fighting, and who might benefit from less treatment.
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