Some medical practitioners are now telling diabetic patients aged 65 or older that it’s okay to have an A1C of 8.0-8.5%. That’s equivalent to blood glucose of 183-197 mg/dL (10.2-10.9 mmol/l)! The rationale of the medical community is that elderly patients cannot follow a strict program of diet and exercise that would enable them to achieve normal blood sugars. In addition, older patients may have other medical/health conditions that are more immediately urgent than controlling their diabetes.
Here’s a typical attitude of the medical community toward elderly diabetics. “For healthy over 65ers with long life expectancy, the target should be 7.0-7.5%. For those with ‘moderate comorbidity’ (so-so health) and a life expectancy of less than 10 years the target should be 7.5-8.0%. And with ‘multiple comorbidities’ such as heart failure, cancer, and dementia the goal should be 8.0-9.0%.”1
Even worse is this article that claims, “Tighter blood glucose control through medication [is] linked to higher death risk.”2 “The study, released this week [November 17, 2017] adds new knowledge by finding that tighter blood glucose control, or lower HbA1c levels, can raise the risk of death among people on intensive blood glucose-lowering therapy.” But here’s the clincher: “However, the findings won’t apply to those achieving excellent HbA1c levels, and experiencing other health benefits, through positive lifestyle change, which inevitably influences mortality risk. People following a low-carb lifestyle without hypo-causing medication, for example, should not be affected.” (Italics mine.)
Another study looked at the “Effect of Aging on A1C Levels in Individuals Without Diabetes,” and concluded that “A1C levels are positively associated with age in non-diabetic populations even after exclusion of subjects with IFG [elevated fasting plasma glucose concentration (≥100 and <126 mg/dl)] and/or IGT [elevated 2-h plasma glucose concentration (≥140 and <200 mg/dl)]. Further studies are needed to determine whether age-specific diagnostic and treatment criteria would be appropriate.”3
Regardless of what the medical and pharmaceutical industries think about older diabetics, I firmly stand with Dr. Richard K. Bernstein in believing that older diabetic patients have just as much right to have normal blood sugar as younger patients and non-diabetics. “[All] diabetics are entitled to the same normal blood sugars as non-diabetics.” (Italics mine.)
“Older adults with poorly controlled diabetes may struggle with what’s known as episodic memory, the ability to recall specific events experienced recently or long ago, a study suggests.”4
While older diabetics are more likely to have co-morbidities along with diabetes, a low-carb way of eating is very likely to improve those conditions, too. The lesson here is that the younger and sooner a diabetic begins a diabetes dietary protocol that will reduce insulin resistance, that is hyperinsulinemia, the better diabetic health they can have as they age.
1Sabin, James. “Overtreatment of elderly diabetics,” Over 65 Blog (July 4, 2014). http://www.over65.thehastingscenter.org/overtreatment-of-elderly-diabetics/ (accessed on 7/31/2020).
2Editor. “Tighter blood glucose control through medication linked to higher death risk,” Diabetes.co.uk (updated November 17, 2017). http://www.diabetes.co.uk/news/2017/nov/tighter-blood-glucose-control-through-medication-linked-to-higher-death-risk-96381539.html (accessed on 7/31/2020).
3Pani, Lydie N., MD, et. al. “Effect of Aging on A1C Levels in Individuals Without Diabetes,” Diabetes Care. 2008 Oct; 31(10): 1991–1996. doi: 10.2337/dc08-0577. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2551641/ (accessed on 7/31/2020).
4Reuters. “Diabetes linked to memory decline in older adults,” Fox News (August 29, 2016). https://www.foxnews.com/health/diabetes-linked-to-memory-decline-in-older-adults (accessed on 7/31/2020).
Additional Information and References
Here are some articles for your perusal. Read through them as you wish and make up your own mind about what you believe. Especially if you are an older diabetic patient or a caregiver of an elderly diabetic person.
Results: A1C Test
THE NORMAL A1C LEVEL
Diabetes linked to memory decline in older adults
Effect of Aging on A1C Levels in Individuals Without Diabetes
Older diabetics may be pushing blood sugar too low
Overtreatment of elderly diabetics
Treatment of type 2 diabetes mellitus in the older patient
Why Hemoglobin A1c Is Not a Reliable Marker
Why Raise Your A1C?
Tighter blood glucose control through medication linked to higher death risk
Here’s the clincher (Italics are mine):
“The study, released this week, adds new knowledge by finding that tighter blood glucose control, or lower HbA1c levels, can raise the risk of death among people on intensive blood glucose-lowering therapy.
“However, the findings won’t apply to those achieving excellent HbA1c levels, and experiencing other health benefits, through positive lifestyle change which inevitably influences mortality risk. People following a low-carb lifestyle without hypo-causing medication, for example, should not be affected.”
Diabetes Advice for the Elderly: Relax