The newest recommendations from the Endocrine Society concerning the elderly and diabetes are surprising, to say the least: lower blood sugar is not always best. And for individuals who have been keeping a routine of finger pricks, insulin injections, and thorough tracking of food consumed, this alteration may be a bit difficult to swallow.
Known as de-intensification, geriatricians are now frequently using the approach with older adults that the advantages to be achieved by striving for exact blood sugar control aren’t outweighing the health risks inherent with the aging process and illness. When A1c and blood sugar levels are kept at really low levels within the elderly, it could contribute to an increased frequency of hypoglycemia and even kidney failure.
With up to one out of three older adults currently identified as having diabetes, these new guidelines are positioned to have a staggering effect on the treatment and management of the disease for seniors, requiring a shift in mindset for all.
And not unexpectedly, many older diabetics are hesitant to embrace this change. In one patient’s statement to Dr. Pei Chen, a geriatrician in the geriatric clinic at the University of California, San Francisco, “I’ve been doing this for 25 years. You don’t need to tell me what to do. I can handle it.”
The new guidelines recommend an increase in A1c from 7 to 7.5% for the elderly who are in good health; and up to 8 – 8.5% for people with dementia, multiple chronic illnesses, or poor health. It’s crucial to note, however, that suggestions are extremely individualized, centered on a number of factors, and that at no time should high blood sugar be neglected in the elderly.
The Alaska home health team at Midnight Sun Home Care can help older adults follow physicians' recommendations to manage diabetes and a number of other conditions with professional, customized, in-home care services for seniors. Just some of the various ways we can assist include: