Should Diabetes Treatment Lessen for Older Adults Approaching the End of Life?

Treating diabetes may be more harmful than beneficial for older adults who have a limited life expectancy or with advanced dementia, an issue explored by a study in the Journal of the American Geriatrics Society , reports Medical Xpress . The researchers analyzed data from Veterans Affairs nursing communities from 2009 to 2015, looking at whether older adults were overtreated for diabetes, whether they had their medication regimens reduced, and what effects might result from lowered doses, types, and/or different kinds of medication. The investigators saw potential overtreatment in almost 44 percent of nursing community admissions for veterans with diabetes and veterans who had limited life expectancy or dementia. Potentially overtreated residents were about 78 years of age and were almost all male and non-Hispanic white. Two-thirds had been brought from hospitals, while 29 percent had advanced dementia, nearly 14 percent were classified with end-of-life status, and 79 percent had a moderately high risk of death within six months. Many were physically dependent with heart disease and/or potential diabetes-related complications, and roughly 9 percent suffered a serious low blood sugar episode in the year prior. Close to half of residents received two or more diabetes medications. Those with higher Hemoglobin A1c (HbA1c) values of 6.5 percent to 7.5 percent received more medications than those with lower HbA1c.