Controlling blood sugar levels has been an age-old marker of good health. And if you’re managing diabetes, it’s something you're regularly tracking to ensure you are in an optimal range.
A1c tests measure the average blood sugar levels over a three-month period. A normal range is considered to be below 5.7%, with prediabetes between 5.7% to 6.4%.
But research indicates that those ranges may be too low for adults 65 and older.
Tight control of blood sugar "was really important when you were 50," Dr. Sei Lee, a geriatrician at the University of California, San Francisco, tells the New York Times about the measurement. “Now, it’s less important.”
The problem is that many older adults have been receiving confusing messaging.
Over-controlling blood sugar in older adults with diabetes may put them at risk for hypoglycemia, also called low blood glucose, which occurs when blood sugar levels drop below 70 mg/dL. Older adults with diabetes are at particular risk for low blood sugar because they are more likely to have other health conditions and it can be a “a less well recognized risk factor for frailty,” per one study.
Hypoglycemia can be dangerous, leading to falls, stroke, and cognitive decline. Severe cases can be fatal. Symptoms include feeling tired, jittery, and dizzy, and at the extreme, people may lose consciousness or have a seizure.
“If you’ve been a diabetic for years, it’s likely you’ve experienced an episode,” Lee told the NYT.
According to the National Institutes of Health, half of Americans with Type 2 diabetes and four in five with Type 1 who take insulin reported at least one low blood sugar event in a four-week period.
Recommendations from the American Geriatrics Society suggest that older adults aim for an A1c measure of 7.5% to 8%, and those with other conditions may be able to go up to 9%. Talk to your doctor about your diabetes management plan, especially if you’ve had low blood sugar episodes.
It can be confusing and frustrating for older adults who have spent decades controlling their blood sugar exactly as they’ve been told. The NYT spoke with an 85-year-old whose daughter shared that "for someone who’s been so compliant all these years, it’s like they changed the rules.”
