Glycemic Control in Older Adults: Applying Recent Evidence to Clinical Practice

Ajay Sood, MD, Division of Clinical and Molecular Endocrinology, Case Western Reserve University School of Medicine; Louis Stokes Cleveland Veterans Affairs (VA) Medical Center, Cleveland, OH, USA.
David C. Aron, MD, MS, Division of Clinical and Molecular Endocrinology, Case Western Reserve University School of Medicine; VA Network 10 Geriatric Research, Education, and Clinical Centers, VA Health Services Research and Development Quality Enhancement Research Initiative Diabetes Clinical Coordinating Center; Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA.

Glycemic goals and the decision to intensify glycemic control among older adults with diabetes must be individualized based on comorbid conditions and the risks associated with treatment. The duration of diabetes mellitus, baseline glycosylated hemoglobin value, prior history of cardiovascular disease, and history of severe hypoglycemia are important factors to consider. This article reviews how the management of diabetes mellitus in this subgroup is changing in view of three recently reported randomized trials of intensive glycemic control.
Key words: diabetes, older adults, glycemic control, cardiovascular disease, glycemic goal.