Q&A: Target Hemoglobin A1C Levels for Older People

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Should older diabetics aim for the same hemoglobin A1C level as younger people?

Doctors often fail to cut back on medications even when treatment goals are surpassed.

There is still confusion when it comes to treating the older population for diabetes, with doctors often not cutting back on medications even when treatment goals are surpassed. One study included more than 211,000 diabetics age 70 and older. The data showed that medications were decreased in just 27 percent of participants with potentially dangerous low blood sugar levels (less than 6 percent as measured by the A1C test, which provides an estimate of blood sugar levels over several months). Another study surveyed nearly 600 physicians, and one-third said they thought their patients could benefit from exceeding treatment guideline goals. However this isn’t the case for older adults, in whom low blood sugar levels are associated with a small but significant increased risk of death, as well as a greater risk for confusion, falls, and hospitalizations. The American Diabetes Association recommends an A1C goal of 7 -7.5% in healthy older adults, and an A1C 8.0%, in those with multiple complex illnesses, functional impairments, or mild-to-moderate cognitive impairment: .

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