Why some doctors want older diabetics to loosen blood sugar control

Doctors are now worried that hypoglycemia may cause falls, broken bones, heart arrhythmias and cognitive damage, and as a result they are recommending that older diabetics may not need to monitor their blood sugars as closely.

In fact, doctors are recommending their older patients keep their A1C higher than they traditionally would as a way to combat episodes of hypoglycemia.

“Most people think about sugar being too high, but low bold sugar can be just as dangerous, especially in seniors. If you fall, fracture a hip or end up in the ER, that changes everything,” Dr. Amit Shah, Mayo Clinic Arizona said.

Hypoglycemia is when someone’s blood sugar drops below 70 mg/dL, with severe cases dipping below 50mg. Doctors are now suggesting keeping A1C levels higher so as not to trigger hypoglycemic episodes.

This is particularly concerning for older adults managing type two diabetes. People with type two diabetics often battle with high blood sugar and medications, especially insulin and other older drugs like sulfonylureas, which can drop the glucose levels too low.

“As you get older, your warning signs become weaker; you may not feel the symptoms as clearly. That makes nighttime particularly risky,” Dr. Shah said.

Dr. Shah emphasized the importance of personal care like being more cautious when one loses weight or starts a new medication.

“One hypoglycaemic episode is a major red flag,” Dr. Shah said. He recommends continuous glucose monitors for patients with previous episodes of hypoglycemia.

“They alarm when levels dip. It can literally save lives,” he said. Doctors are urging older adults to balance their blood sugar and not overcorrect it.

“It takes years for complications from high sugar to show up,” Dr. Shah said. “But hypoglycemia can knock you down in one night.”