Too Much of a Good Thing: Some Diabetes Patients Overtreated

Diabetes patients who are overtreated may have dangerously low blood sugar

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Like Goldilocks and her porridge, people with diabetes need their blood sugar "just right." In some cases, though, diabetes treatment for older adults with other health problems can be overly strict, which may cause blood sugar problems.

A new study found that older patients with diabetes may face a high risk of low blood sugar and can actually be overtreated. Older people with diabetes often have other health problems like kidney disease.

Attempting to keep blood sugar at the same level as that used for younger, relatively healthy people with diabetes can increase the risk of complications in older adults, according to the American Geriatrics Society. The authors of this study said health professionals should carefully assess older people with diabetes to ensure they are not overtreated.

"These vulnerable adults are unlikely to experience the benefits of intensive [blood sugar] control and instead are likely to experience harms from treatment, such as hypoglycemia and other adverse effects," the authors of this study wrote.

For this study, Kasia J. Lipska, MD, MHS, of the Yale School of Medicine in New Haven, CT, and colleagues studied data on around 1,200 people with diabetes to estimate the potential for overtreatment.

The goal of diabetes treatment is to keep the patient’s blood sugar within a somewhat narrow range. Both high and low blood sugar — hyperglycemia and hypoglycemia, respectively — can increase the risk of complications like kidney disease and blindness.

Insulin and sulfonylureas lower blood sugar, and these medications can increase the risk of hypoglycemia. People who have both diabetes and other health problems can become sick if their blood sugar drops too low.

The blood sugar in almost 62 percent of the patients in this study was below the recommended level. Slightly more than half the study patients were being treated with either insulin or sulfonylureas.

Dr. Lipska and team estimated that, in the US, at least 1 million older patients with diabetes were overtreated, which could increase the risk of low blood sugar.

This study was published Jan. 12 in JAMA Internal Medicine.

This research was funded by the Pepper Center Career Development Award, the National Institute on Aging, the American Federation for Aging Research and the National Institutes of Health, among others.

Dr. Lipska and study author Dr. Joseph S. Ross received support from the Centers for Medicare and Medicaid Services, as well as other groups involved in clinical trial data gathering.

Review Date: 
January 9, 2015
Last Updated:
January 13, 2015