Setting realistic, safe goals. The 2012 position
statement on the management of hyperglycemia in
type 2 diabetes from the American Diabetes Association
(ADA) and the European Association for the
Study of Diabetes offers recommendations for diabetes
care in older adults based on functional status,
overall health, and comorbidities.3 According to these
guidelines, an HbA1c level of less than 7.5% to 8%, or
even higher, may be an appropriate goal for an older
adult with a history of multiple comorbidities or hypoglycemia,
and a shorter life expectancy. Tighter control,
with an HbA1c goal of less than 6.5% to 7%,
may be more appropriate for healthy older adults
with a long life expectancy. A 2012 consensus report
from the ADA and the American Geriatrics Society
makes similar recommendations: an HbA1c level of
less than 8.5% for older adults in poor health (longterm
care, end-stage chronic illnesses, or cognitive impairment)
and a goal of less than 7.5% for healthy
older adults.13 In all cases, it’s important to consider
whether these goals can be attained without undue
Setting realistic, safe goals. The 2012 positionstatement on the management of hyperglycemia intype 2 diabetes from the American Diabetes Association(ADA) and the European Association for theStudy of Diabetes offers recommendations for diabetescare in older adults based on functional status,overall health, and comorbidities.3 According to theseguidelines, an HbA1c level of less than 7.5% to 8%, oreven higher, may be an appropriate goal for an olderadult with a history of multiple comorbidities or hypoglycemia,and a shorter life expectancy. Tighter control,with an HbA1c goal of less than 6.5% to 7%,may be more appropriate for healthy older adultswith a long life expectancy. A 2012 consensus reportfrom the ADA and the American Geriatrics Societymakes similar recommendations: an HbA1c level ofless than 8.5% for older adults in poor health (longtermcare, end-stage chronic illnesses, or cognitive impairment)and a goal of less than 7.5% for healthyolder adults.13 In all cases, it’s important to considerwhether these goals can be attained without undue
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