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JAMA Clinical Guidelines Synopsis
October 13, 2015

Glycemic Control in Older Adults With Diabetes Mellitus

Author Affiliations
  • 1Section of General Internal Medicine, University of Chicago, Chicago, Illinois
JAMA. 2015;314(14):1509-1510. doi:10.1001/jama.2015.8345

Diabetes in older adults presents a significant public health challenge. The prevalence of the disease increases sharply with age, affecting 12.2% of adults aged 45 to 64 years but 21.8% of adults aged 65 to 74 years.1 Historically, diabetes treatment goals have included achieving near-normal levels of glucose (HbA1c <7%), blood pressure (<130/80 mm Hg), and low-density lipoprotein cholesterol (<100 mg/dL [<2.59 mmol/L])2 to reduce the risk of complications. However, clinical trials that inform diabetes recommendations have tended to exclude older patients and those with significant comorbid illnesses. Thus, risk factor target goals are unclear in older patients who have numerous comorbidities and diminished functional status.