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Invited Commentary
July 22, 2013

Glucose Control in Older Adults With Diabetes Mellitus—More Harm Than Good?

Author Affiliations
  • 1Section of Endocrinology, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut
  • 2Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota
JAMA Intern Med. 2013;173(14):1306-1307. doi:10.1001/jamainternmed.2013.6189

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?

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