Now, Ura Larson recognizes what is happening. She said, “It seems that you are shaking inside.” “I am while I am worried.” If someone asks if she wants to have a salad for lunch, she does not know how to respond.
She had many episodes this year, and it appears to be frequently coming.
“She stares and gets a gray color and then feels confused.” “It is really scary.”
Lack of blood sugar occurs when blood sugar levels or glucose decrease. Read less than 70 milligrams per decelter is an acceptable definition. Any person can affect medications to lower glucose to control the condition.
But it occurs frequently in advanced ages. “If you have diabetes for years, you are likely to have faced an episode,” said Dr. Cie Lee, an old age doctor at the University of California, San Francisco, who is looking for diabetes in the elderly.
Mrs. Larson, 85, was injured, diabetes 2 for decades. Now her physician and primary care doctor fear that hypoglycemia may cause fall, broken bones, irregular heartbeat and cognitive damage.
Both advised her to allow her to hemoglobin A1C, a measure of the average glucose in the blood over several months, rising 7 percent. “They say:” Do not worry much about the heights – we want to prevent their lowest levels, “said Ms. Larson, the youngest.
But her mother spent 35 years working to maintain A1C less than 7 percent – a common recommendation, and the goal of people singing and dancing in commercial advertisements for drugs.
She is honestly injected with her prescribed medicine, Vikosa, about three times a week and see her diet. It is the oldest member of the Aqua for Erthritis category in a local group in Saint -Paul, Minnesota.
So when its doctors recommended the A1C above, she resisted. She said, “I think it’s a handful of hoody.” “It was not logical to me.”
“She got a lot of encouragement and recognition of her doctors by controlling diabetes and staying on his head,” her daughter explained. “They have always praised her” narrow control. “
“For a person who was compatible with all these years, it seems as if he is not the rules.”
In fact, they have.
More than a decade ago, The American Aging Association called on the A1C Himoglobin from 7.5 to 8 for most older adults With diabetes, 8 to 9 percent for those who compete with multiple chronic diseases and limited life. (Mrs. Lady Larson has multiple and high blood pressure.)
Other medical societies and advocacy groups, including American Diabetes Association and Endocrine communityThey also reviewed their instructions to the older patients.
Tadrani treatment can include relaxation to stop the drug, reduce the dose, or switch to another drug-an approach called adaptation cancellation.
The appearance of effective new diabetes-GLP-1 receptors (such as OzemPIC) and SGLT2 inhibitors (such as jardiance)-changed the scene. Some patients can replace these safer drugs for the most harmful damage.
But new drugs can complicate decisions, because not all older patients can switch – and for those who can, insurance companies may be swinging in the signs of new high -prices for prices and denial of coverage.
So canceling reproduction is to move forward, however Very gradually.
2021 Study the beneficiaries of medical care with diabetesFor example, they looked at the patients who went to the emergency room or were taken to the hospital due to hypoglycemia. It was less than half of the uninterrupted drug systems within 100 days.
“House residents nursing Dr. Joseph Oselnder, an old age doctor at the University of Florida Atlantic and the editor of the American Aging Association Journal, said.
Last 2021 A study, from the role of the elderly care in OntarioI found that more than half of the population who takes medications for type 2 diabetes had A1C levels less than 7 percent. Those who suffer from the greatest perception of perception were treated more strongly.
Dr. Oselnder’s account, based on PatriotismNearly 40,000 visits in the emergency room annually resulted from excessive treatment of diabetes in the elderly from 2007 to 2011. It is believed that the numbers are likely to be much higher.
Short Introduction: Diabetes can cause these linear complications-heart attacks, stroke, vision, hearing loss, chronic kidney disease, and amputation-the so-called strict blood sugar control in the small and medium age.
But narrow control, such as every medical treatment, involves a period of time before it is paid in improving health. With diabetes, it is a long time, and perhaps from eight to 10 years.
The elderly who are already competing with a variety of health problems may not live for a long time to take advantage of narrow control anymore. “It was really important when you were 50 years old,” said Dr. Lee. “Now, this is less important.”
The older diabetics do not always welcome this news. “I thought they would be happy,” said Dr. Lee. He added: “It seems as if I am trying to take something away from them.”
Risk that narrow control will also lead to increased hypoglycemia with patients age at the age of patients.
People can smell sweat, panic, tired. “People can lose consciousness,” said Dr. Scott Bilala, a subcontractor and diabetes researcher at Jones Hopkins. “It can become confused. If they are driving their car, they may have an accident.”
Even the most moderate blood sugar sugar events “can become a problem of life if it occurs frequently”, ” Anxiety He added in patients and may lead them to reduce their activities.
Experts indicate two types of old drugs involved in hypoglycemia: insulin and Salvonelias Like Gleipizide and GLIMEPIRIEDE.
For people with type 1 diabetes, whose bodies cannot produce insulin, the hormone injection remains necessary. Dr. Lee said that the drug “is widely recognized as a dangerous drug” due to the risk of hypoglycemia and should be carefully monitored.
He added that sulfonoria “has become less used” because, although it is less dangerous than insulin, it also causes hypoglycemia.
The vast majority of elderly people with diabetes have type 2, giving them more options. They can complete the mitphormin drug prescribed with the most recent GLP-1 and SGLT2 drugs, which also have benefits for the heart and kidneys. If necessary, they can add insulin to their systems.
Among the consequences of the most popular new drugs is weight loss.
“For the elderly, if they are weak and not very active, we do not want them to lose their weight,” Dr. Bella pointed out. Both metformin, GLP-1 and SGLT-2 medications can be infectious or irrigation side effects.
For 15 years, Dan Marsh, 69, who is an accountant in the media, Pennsylvania, treated type 2 diabetes by injecting two forms of insulin per day. He said that when he takes a lot, he wakes up at night with his “lowest level”, and needs to eat and take glucose tablets.
However, the A1C is still high, and last year the doctors spoiled part of the toe. Because he takes many other medications for a variety of cases, he and his doctor decided not to try different diabetes medications.
Mr. Marsh said: “I know that there are other things, but we did not go this way.”
With all new options, including continuous glucose screens, “discovering optimal treatment has become more and more difficult,” said Dr. Bella.
The bottom line, although “the elderly exaggerate blood sugar and reduce the risk of their medications.” mostly, Their doctors did not explain how the baccalaureate turns with age Health problems accumulate.
Ura Larson, which carries chewed glucose tablets with her in the event of a hypoglycemia (fruit juice and desserts are also the famous antidote), plans to talk about the treatment of diabetes with its doctors.
It is a good idea. “The largest risk factor for severe blood sugar is a lack of blood sugar before,” said Dr. Lee.
“If you have one episode, it should be considered a warning signal. Your doctor should know that, why this happened? What can we do so that the sugar level in your blood does not decrease dangerously?”
