Harm Of Overly Tight Control Of Blood Sugar Level

Harm Of Overly Tight Control Of Blood Sugar Level.
Many older woman in the street with diabetes may be exposed to potency wickedness because doctors are trying to living overly tight control of their blood sugar levels, a experimental study argues. Researchers found that nearly two-thirds of older diabetics who are in ill-fated health have been placed on a diabetes management regimen that strictly controls their blood sugar, aiming at a targeted hemoglobin A1C unalterable of less than 7 percent cytotec bisa di beli diapotik surabaya. But these patients are achieving that purpose through the use of medications that neighbourhood them at greater risk of hypoglycemia, a revenge to overly low blood sugar that can cause abnormal heart rhythms, and dizziness or forfeiture of consciousness, the researchers said.

Further, tight diabetes mastery did not appear to benefit the patients, the researchers report Jan 12, 2015 in JAMA Internal Medicine. The share of seniors with diabetes in straitened health did not change in more than a decade, even though many had undergone years of hostile blood sugar treatment. "There is increasing trace that tight blood sugar control can cause abuse in older people, and older people are more susceptible to hypoglycemia," said leading position author Dr Kasia Lipska, an subsidiary professor of endocrinology at Yale University School of Medicine.

So "More than half of these patients were being treated with medications that are uncongenial to benefit them and can cause problems". Diabetes is routine among people 65 and older. But doctors have struggled to come up with the best headway to manage diabetes in seniors alongside the other fitness problems they typically have, researchers said in curriculum vitae information with the study. For younger and healthier adults, the American Diabetes Association has recommended psychoanalysis that aims at a hemoglobin A1C destroy of lower than 7 percent, while the American Association of Clinical Endocrinologists recommends a object of turn down than 6,5 percent, the authors noted.

The A1C test provides a conceive of of your average blood sugar levels for the past two to three months. By closely controlling blood sugar levels, doctors craving to stave off the complications of diabetes, including implement damage, blindness, and amputations due to nerve hurt in the limbs. In this study, the authors analyzed 2001-2010 evidence on 1,288 diabetes patients 65 and older from a US survey. The patients were divided into three groups based on their strength status: About half were considered less hale despite their diabetes; 28 percent had complex/intermediate health, in that they also suffered from three or more other lasting conditions or had difficulty performing some fundamental daily activities.

Roughly 21 percent had very complex/poor health, and were either dependent on dialysis or struggling with activities of ordinary living. Overall, 61,5 percent of all these patients had achieved snug blood glucose control. And a sparse more than half of them had done so by relying on drugs that can dramatically demean blood sugar levels. These comprise insulin and sulfonylureas, a medication that prompts the pancreas to produce more insulin.

People with diabetes either don't grow insulin, a hormone needed to change food into energy, or cells don't process it properly. Despite this bellicose treatment, the proportions of older diabetics in morality and poor health did not significantly change during the 10-year study period, speciality into question whether doctors are overtreating these patients to no real help "I don't think we should be using insulin or sulfonylureas in older patients.

This cram shows that with people in poorer health, we're treating them aggressively with these drugs, and it makes no difference". Dr Alan Garber, of the Baylor College of Medicine in Houston, said the bone up does phone call into uncertainty the use of insulin or sulfonylureas to treat diabetes in older adults, but does not to be sure invalidate the goal of tight blood sugar control. "I bump into it very interesting that the study shows that decided medications produce adverse outcomes, but concludes that the aim of treatment is the problem and not the medication," said Garber, a professor of diabetes, endocrinology and metabolism.

So "An equally valid conclusion is that it shows that many of the newer medications, which have been proven in multiple trials to have of a higher order outcomes with regards to hypoglycemia, should have been reach-me-down in patients at hazard for hypoglycemia". However, both Garber and Lipska agreed that for older patients with diabetes, a "one-size-fits-all" diabetes curing organize will not work.

And "We miss to individualize diabetes management, including the goals. For some individuals, the unwritten goals are perhaps too low for their talent to tolerate it. On the other hand, you have to try them on medications with a muffled risk of hypoglycemia". Lipska said she would "encourage subjects to talk with their physicians and to try to understand better what are the potential benefits and what are the risks of treatment male tens placement orgasm. There isn't one widespread goal for everyone".