Study: Physicians may be over-treating seniors for diabetes

January 21, 2015

A new study published recently in the Journal of the American Medical Association Internal Medicine, found that physicians may be over-treating some older adult diabetic patients resulting in greater health threats from the diabetes medications prescribed to them.

Older adults with diabetes may be experiencing more harm than good from their treatments, according to a new report.

A new study published recently in the Journal of the American Medical Association Internal Medicine, found that physicians may be over-treating some older adult diabetic patients resulting in greater health threats from the diabetes medications prescribed to them. 

The study used data from the National Health and Nutrition Examination Survey conducted among more than 12,000 adults with diabetes over the age of 65 from 2001 to 2010. Study patients were categorized as relatively healthy, in intermediate health due to complex medical histories, or poor health due with limited life expectancy due to comorbid illness.

According to the report, having too tight of control over blood sugar raises the risk of hypoglycemia and the need for hospitalization due to adverse drug effects.

“Although the harms of intensive treatment likely exceed the benefits for older patients with complex/intermediate or very complex/poor health status, most of these adults reached tight glycemic targets between 2001 and 2010,” the study concluded. “Most of them were treated with insulin or sulfonylureas, which may lead to severe hypoglycemia. Our findings suggest that a substantial proportion of older adults with diabetes were potentially over-treated.”

More than 60% of older adult patients in the study had a hemoglobin level less than the recommended 7%, yet two-thirds of them were treated with either insulin or sulfonylurea medicines.
“These vulnerable adults are unlikely to experience the benefits of intensive glycemic control and instead are likely to experience harms from treatment, such as hypoglycemia and other adverse effects,” the study authors note. “Recognition of both the harms and benefits of glycemic control is critical for patients and physicians and other healthcare professionals to make informed decisions about glucose-lowering treatment.” 

The American Diabetes Association recommends and A1C level of less than 8% for those in intermediate health, but says patients with shorter life expectancies or comorbidities should maintain A1C levels of around 8.5%.

Roughly 20% of adults over the age of 65 suffer from diabetes, and that number is expected to double over the next two decades, with medical costs related to their diabetes care tripling, according to the new study.