Aggressive Diabetes Treatment May Harm Some Patients

Aggressive Diabetes Treatment May Harm Some Patients
Glucometer, diabetes medication, and insulin syringe.

Many people who have diabetes, particularly seniors, are so aggressively treated for the condition with many drugs that it may be putting them at risk for dangerously low blood sugar levels.

Researchers examined data on more than 31,000 adults with type 2 diabetes. About 20% of those studied were considered aggressively treated if they were taking multiple medications to keep their blood sugar levels under control. In particular, researchers wanted to see how often this group had such low blood sugar levels that it led to health problems requiring hospitalization or other medical treatment.

About 4,000 of the subjects were at least 75 years old and/or had additional health issues. During the 2-year study period, 19% of this “high clinical complexity” group received intensive blood sugar lowering therapy. Among this group, the risk for severe hypoglycemia requiring medical care was 3%, compared with just 1.7% for the high-complexity patients not receiving intensive treatment.

Such aggressive treatment led to a slew of side effects in some patients, including dizziness and fainting, and in severe cases, seizures and coma. Details of the study were published in JAMA Internal Medicine.

Researchers pointed to some of the reasons for the overtreatment, including guidelines and recommendations that emphasize blood sugar reduction without alerting patients to the risk of what happens when low blood sugar occurs.

“Balancing the medical profession’s focus on aggressively treating patients who are likely to benefit with an explicit consideration of when to deintensify treatments when they are no longer useful or are potentially harmful, and doing so in a manner that is respectful to the patient-physician relationship and promotes shared decision making, is the next frontier for improving care quality,” Eve A. Kerr, MD, of and Timothy P. Hofer, MD, both of the University of Michigan Medical School, wrote in an editorial accompanying the study.

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