Potential Overtreatment of Diabetes Mellitus in Older Adults With Tight Glycemic Control

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Abstract
Diabetes mellitus is highly prevalent among older persons (≥65 years),1 yet optimal glucose management in this population remains ill-defined. For younger, healthier adults, the American Diabetes Association (ADA) recommends glycemic control to achieve a hemoglobin A1c (HbA1c) level of less than 7% (to convert to proportion of total hemoglobin, multiply by 0.01), while the American Association of Clinical Endocrinologists (AACE) recommends an HbA1c level of less than 6.5% to reduce the risk of microvascular complications.2,3 However, older persons, particularly those with complex medical problems, may derive less benefit from intensive strategies to lower glucose levels4,5 and are more susceptible to hypoglycemia and its consequences compared with younger, healthier persons.6

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