Control blood sugar
About half to three-quarters of all older adults are diagnosed with prediabetes. But what does that mean? And what do you have to do in the event you receive such a diagnosis? More and more experts are advising older patients to not overreact.
A diagnosis of type 2 prediabetes often causes fear and confusion in older people. It can result in unnecessary tests and medications. And if poorly managed, treatment can lower blood sugar an excessive amount of, which for a lot of older people is more dangerous than diabetes itself – high blood sugar.
It is essential to keep in mind that a diagnosis of prediabetes doesn’t mean that you just are at high risk of developing diabetes. A 2021 study by Mary C. Rooney of Johns Hopkins University and colleagues found that hardly one in ten older patients with prediabetes progress to full-blown diabetes inside 6.5 years. In fact, they’re much more prone to return to normal blood sugar levels or die from one other disease than to change into diabetic. Their article was published within the journal JAMA Internal Medicine.
Don’t overreact
Their findings don’t mean that older patients should ignore elevated biomarkers. But they do mean that they and their doctors should proceed with caution.
Most older people can reply to elevated – although not excessively high – blood sugar (or glucose) levels with small lifestyle changes, resembling eating higher or getting more exercise. Most of those changes are appropriate for all seniors.
Other measures resembling frequent check-ups or medication could also be unnecessary and even dangerous.
The situation is different for younger people or people of any age that suffer from heart disease or obesity, where more aggressive treatment is usually appropriate.
Understanding diabetes
diabetes might be treated. However, if left untreated, it could result in heart disease, nerve damage, blindness and hearing loss.
About 37 million Americans have diabetes. The average annual cost of treatment is $12,000, and overall the United States spends greater than $300 billion on medical costs directly related to the disease. in keeping with a brand new study by Emily Parker of the consulting firm Lewin Group and colleagues.
It’s necessary to know if you’ve diabetes or are at high risk of developing it. But prediabetes just isn’t diabetes, and for older adults, it is not even a very good indicator that they may develop the disease. “Potting people into a box creates a lot of fear,” says Judith Fradkin, former director of the diabetes program on the NIH. “Younger people may be at risk. But in older people, glucose levels progress much more slowly.”
Doctors use different tests to measure blood sugar (or glucose). The most typical is the A1c level. If that is 6.5 or higher, it is taken into account type 2 diabetes.
Prediabetes is different
Prediabetes is something else entirely. There are five different tests and definitions for prediabetes, a few of that are more reliable than others. If your doctor uses the A1c test, prediabetes will show up somewhere on a scale between 5.7 and 6.4.
But what does that mean? Well, just that your A1c level is just a little higher than normal. But the tests themselves aren’t perfect.
Rooney and her colleagues found that over 6.5 years, fewer than 12 percent of the older prediabetes patients she cared for ever developed diabetes. Some tests found the likelihood of developing diabetes was even lower.
Risks of overtreatment
The consequences of overreacting to a prediabetes diagnosis might be serious. For example, The American Diabetes Association recommends screening “at least” yearly for individuals with prediabetes. And some doctors recommend testing every six months. But these tests cost money and may result in much more stress.
Rooney and colleagues say their study “highlights the potential futility of aggressive diabetes screening in older adults.” An earlier study by other researchers at Johns Hopkins got here to a largely similar conclusion.
Likewise, drug therapies could also be unsuitable for most individuals with prediabetes.
Metformin is the usual drug for diabetesIt lowers blood sugar levels, but is usually accompanied by unpleasant uncomfortable side effects resembling diarrhea, or more serious but less common ones, resembling confusion or respiration problems. It can also be not suitable for elderly patients with kidney disease. Fradkin and other experts say metformin mustn’t be taken for prediabetes.
Go for a stroll
In a recent article in Annals of Family MedicineRani Marx, herself a physician, wrote about her own experience of being diagnosed with prediabetes. Her conclusion: “A strict interpretation of marginal test results can lead to overdiagnosis and overtreatment… I and many others are overdiagnosed.”
What do you have to do in the event you’re diagnosed with prediabetes? First, take a deep breath. It’s not the top of the world. Then, ask your doctor a number of questions. Find out how this condition pertains to other health problems you could have. Then, go for a pleasant long walk. It is perhaps the perfect thing you’ll be able to do for yourself.
