Ms Andrews, your 83-year-old patient, is proud. She walks daily, watches her diet, and never misses her appointments. Her glycated hemoglobin (HbA1c) level is 6.9%. As she readies to leave, you notice her bruised arm. It is from one of her fainting spells, she says. After asking a few more questions, you realize she has been having hypoglycemic episodes, including at least 1 last week in which she lost consciousness and needed her son’s assistance. Perhaps not all is as it seems. Based on multiple performance metrics, her care has been exemplary. But has your treatment caused more harm than good?
Lipska KJ, Montori VM. Glucose Control in Older Adults With Diabetes Mellitus—More Harm Than Good?. JAMA Intern Med. 2013;173(14):1306-1307. doi:10.1001/jamainternmed.2013.6189