Elderly Type 2 Diabetes Patients May Be Overtreated

| June 12, 2017

Elderly people with chronic illnesses often put a lot of faith in their doctor. And, if an old person dies from complications of their illness, doctors don’t want to think that they might have done more to prevent it. The result is that many older people are overprescribed medications – and suffer the side effects that come with them.

Researchers at Leicester University recently found this was the case in elderly people with type 2 diabetes.1 They examined the GP surgery records of 1,379 people over 70 years old with type 2 diabetes, who were being prescribed either a sulphonylurea drug or insulin. Of these patients, 644 also had chronic kidney disease and 60 had dementia.

Analysis showed that 30 per cent of the participants had glycated haemoglobin (HbA1c) values below 53 mmol/mol (7 per cent in US measurements), which the researchers considered to be ‘potential overtreatment’ of diabetes. Some 35 per cent of patients taking sulphonylurea drugs were being overtreated and 24 per cent of those on insulin.

The main danger from such overtreatment is the risk of hypoglycaemia. A hypoglycaemic attack can be particularly dangerous in an older person, and having chronic kidney disease or dementia increases the risk of one happening. In addition, suffering repeated hypos accelerates both a decline in kidney function and the progression of dementia. If that weren’t bad enough, insulin and sulphonylurea drugs also increase the chances of a heart attack or stroke, as I mentioned here.

If there is an older person you care about who has type 2 diabetes, ask them about their treatment and their blood test results. And, especially if it is a close family member, don’t think twice about having a word with their doctor to see whether their medication could be reduced, perhaps combined with some dietary changes and nutritional supplements.

An often-overlooked complication of diabetes is atrial fibrillation or aheart flutter, which is a more dangerous condition than you might think. But you could reduce your risk with a surprising and delicious nutritional fix, as I explain in my next blog post.

Wishing you the best of health,

Martin Hum
PhD DHD Nutritionist
for Real Diabetes Truth

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1. Hambling CE, Seidu S, Davies MJ, Khunti K. Older people with Type 2 diabetes, including those with chronic kidney disease or dementia, are commonly overtreated with sulfonylurea or insulin therapies. Diabet Med. 2017 May 12 (Online ahead of print).

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