"The groundwork of all happiness is health." - Leigh Hunt

Is tight blood sugar control appropriate for older adults with diabetes?

It is understood that uncontrolled diabetes damages the vital organs of the body like heart, kidney, eyes, nerves, blood vessels and brain. Therefore, it can be crucial to ask how well blood glucose (also generally known as blood sugar) ought to be controlled to reduce the danger of harm to those organs.

Blood Sugar: Too High, Too Low, or Just Right?

To answer this query, let's first discuss how diabetes differs from other chronic health conditions. For example, a health care provider may let you know that your cholesterol level should be below a certain number to scale back your risk of heart disease. Diabetes is different. Diabetes is a novel condition wherein each high and low glucose levels are harmful to the body.

Diabetes control is measured as A1c, which shows average blood sugar levels over the past two to a few months. High glucose levels (A1c levels above 7% or 7.5%) can damage major organs within the body over an extended time frame. However, medications and insulin which are used to lower glucose levels can result in very high glucose levels which are too low. Low glucose levels (called hypoglycemia) may end up in symptoms similar to a quick heart rate, excessive sweating, dizziness, trouble considering, falling, and even passing out.

Therefore, each high and low glucose levels are harmful. Thus, managing diabetes requires balancing the danger of high and low glucose levels, and requires constant assessment to see which of those glucose levels is more prone to harm a person. It is feasible.

Different Lifetime Blood Sugar Goals

The next consideration in answering the query of tight glucose control is to grasp why younger and older adults need different goals. In younger people, longer life means a better risk of developing complications over several a long time of life. Young adults normally get well from hypoglycemic episodes without serious consequences.

On the opposite hand, people of their 80s or 90s may not have a life expectancy of several a long time, and so there may be less concern about long-term complications from high glucose levels. However, hypoglycemia in these individuals can result in immediate consequences similar to falls, fractures, lack of independence, and consequent reduction in quality of life.

In addition, tight control of diabetes often requires complex treatments, similar to multiple insulin injections at different times of the day or multiple glucose-lowering tablets. This further increases the danger of hypoglycemia in addition to stress for each elderly patients and their caregivers at home.

Identifying the reason for blood sugar control

Thus, when considering blood glucose targets in older adults, it can be crucial to ask why we're managing diabetes. Because the explanation for tightly controlling diabetes is to forestall future complications, tight control of diabetes could also be a goal in older adults who're in good health and have few risk aspects for hypoglycemia. Risk aspects for hypoglycemia include a previous history of severe hypoglycemia that required hospital or emergency department visits, memory problems, physical weakness, vision problems, and serious medical conditions similar to heart, lung, or kidney disease.

In elderly individuals with multiple risk aspects for hypoglycemia, the goal mustn't be tight control. Instead, the goal ought to be the most effective control that might be achieved without putting the person in danger for hypoglycemia.

Finally, it can be crucial to do not forget that health status shouldn't be at all times stable as we age, and the necessity or ability to take care of tight glucose control may change over time in older adults. All chronic disease goals, not only blood sugar control, should be individualized to adapt to the changing conditions related to aging.