MILWAUKEE — Many older people with diabetes who have other health problems have been kept on intensive and potentially harmful blood sugar control regimens, according to the paper published Monday in JAMA Internal Medicine.

Diabetes is common in people 65 and older. However, it is questionable how much benefit they get from being kept on drugs that tightly control their blood sugar, the research found. Doing so can actually cause harm, including dangerously low blood sugar.

“The risks appear to outweigh the benefits,” said lead author Kasia Lipska, an assistant professor of medicine and diabetes specialist at Yale School of Medicine. “We know that older people are at special risk.”

The paper echoes concerns raised last month in a Milwaukee Journal Sentinel/MedPage Today investigation of the diabetes drug industry. The investigation found all 30 diabetes drugs approved by the U.S. Food and Drug Administration over the past decade were OK’d based on the ability to lower blood-sugar levels, not proven benefits such as fewer heart attacks or strokes.


Type 2 diabetes is a serious problem in America, often requiring drugs. The condition can lead to cardiovascular disease, kidney failure, amputations and more immediate symptoms.

The surging number of cases has closely paralleled increasing rates of obesity, sedentary living and an aging population.

But the number of people with diabetes or pre-diabetes and who are candidates for drugs has been magnified by organizations and doctors with financial ties to drug companies, the investigation found.

For the new study, researchers analyzed data collected from 1,288 people aged 65 and older for the years 2001 through 2010.


Depending on their health, they were put into three categories: relatively healthy; those with complex medical histories for whom self-care was difficult; and those with a very significant additional illness and functional impairment, many of whom had limited life expectancy.

Among those 65 and older in the United States, they represented 3.1 million relatively heathy Americans; 1.7 million with intermediate health; and 1.3 million with poor health. Yet, there was little difference in how intensively their blood sugar was being controlled, the paper found.

About 60 percent of all three groups had blood sugar that was being kept low, based on a blood test known as hemoglobin A1C.

“These vulnerable adults are unlikely to experience the benefits of intensive glycemic control and instead are likely to experience harms from treatment,” the authors wrote.

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