It is understood that uncontrolled diabetes damages the vital organs of the body like heart, kidney, eyes, nerves, blood vessels and brain. Therefore, it can be crucial to ask how well blood glucose (also often called blood sugar) must be controlled to attenuate the danger of harm to those organs.
Blood Sugar: Too High, Too Low, or Just Right?
To answer this query, let's first discuss how diabetes differs from other chronic health conditions. For example, a physician may let you know that your cholesterol level have to be below a certain number to scale back your risk of heart disease. Diabetes is different. Diabetes is a novel condition by which each high and low glucose levels are harmful to the body.
Diabetes control is measured as A1c, which shows average blood sugar levels over the past two to 3 months. High glucose levels (A1c levels above 7% or 7.5%) can damage major organs within the body over an extended time frame. However, medications and insulin which can be used to lower glucose levels can result in very high glucose levels which can be too low. Low glucose levels (called hypoglycemia) may end up in symptoms similar to a quick heart rate, excessive sweating, dizziness, trouble considering, falling, and even passing out.
Therefore, each high and low glucose levels are harmful. Thus, managing diabetes requires balancing the danger of high and low glucose levels, and requires constant assessment to see which of those glucose levels is more prone to harm a person. It is feasible.
Different Lifetime Blood Sugar Goals
The next consideration in answering the query of tight glucose control is to grasp why younger and older adults need different goals. In younger people, longer life means a better risk of developing complications over several many years of life. Young adults normally get well from hypoglycemic episodes without serious consequences.
On the opposite hand, people of their 80s or 90s may not have a life expectancy of several many years, and so there's less concern about long-term complications from high glucose levels. However, hypoglycemia in these individuals can result in immediate consequences similar to falls, fractures, lack of independence, and consequent reduction in quality of life.
In addition, tight control of diabetes often requires complex treatments, similar to multiple insulin injections at different times of the day or multiple glucose-lowering tablets. This further increases the danger of hypoglycemia in addition to stress for each elderly patients and their caregivers at home.
Identifying the explanation for blood sugar control
Thus, when considering blood glucose targets in older adults, it can be crucial to ask why we're managing diabetes. Because the rationale for tightly controlling diabetes is to stop future complications, tight control of diabetes could also be a goal in older adults who're in good health and have few risk aspects for hypoglycemia. Risk aspects for hypoglycemia include a previous history of severe hypoglycemia that required hospital or emergency department visits, memory problems, physical weakness, vision problems, and serious medical conditions similar to heart, lung, or kidney disease.
In elderly individuals with multiple risk aspects for hypoglycemia, the goal shouldn't be tight control. Instead, the goal must be the most effective control that may be achieved without putting the person in danger for hypoglycemia.
Finally, it can be crucial to do not forget that health status is just not all the time stable as we age, and the necessity or ability to keep up tight glucose control may change over time in older adults. All chronic disease goals, not only blood sugar control, should be individualized to adapt to the changing conditions related to aging.