According to the ADA and AGS, how should goals for glycemia, blood pressure, and dyslipidemia be adjusted for elderly patients?

Updated: Oct 23, 2019
  • Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
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Answer

For patients older than 65 years, a recent consensus statement from the American Diabetes Association and the American Geriatrics Society recommends adjusting treatment goals for glycemia, blood pressure, and dyslipidemia according to life expectancy and the presence of comorbidities. The statement suggests 3 broad groupings [248, 249] :

  • Healthy: Patients with few coexisting chronic conditions and intact cognitive and functional status

  • Complex/intermediate: Patients with multiple coexisting chronic illnesses or 2 or more impairments in activities of daily living (ADL) or mild to moderate cognitive impairment

  • Very complex/poor health: Patients in long-term care or with end-stage chronic illnesses or moderate to severe cognitive impairment or with 2 or more ADL dependencies

Corresponding HbA1c targets might be less than 7.5%, less than 8%, and less than 8.5%, respectively, for the 3 groups above.


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