Hey @A DiabetesTeam Member

This is a paragraph from a piece published in the Harvard Journal from a couple of years ago that give the answer to that question - and it does make "total medical sense"

(quote)

Elderly patients, and those with serious medical conditions, will benefit from simply controlling the symptoms they have from high blood sugars, like frequent urination and incontinence, rather than aiming for any particular A1c level.

Who would be included in this group?

People with a life expectancy of less than 10 years, or those who have advanced forms of dementia, emphysema, or cancer; or end-stage kidney, liver, or heart failure.

There is little to no evidence for any meaningful benefit of intervening to achieve a target A1c in these populations; there is plenty of evidence for harm.

In particular, diabetes medications can cause low blood sugars, leading to weakness, dizziness, and falls.

There is the added consideration that elderly and sick patients often end up on a long list of medications that can (and do) interact, causing even more side effects.

(unquote)

I have never put it so eloquently. My own statement tends to be "without being morbid, if the patient is advanced in age is there really any need to try and protect against a complication that may take 20 years to develop?

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A Diabete...

@A DiabetesTeam Member at your age an A1C of 7.0 or 7.5 might be "good enough"

I'm not trying to be morbid here but treatment guidelines are established to consider age and total health

Above the age of 70 statistically, if you are otherwise in good health, you don't live long enough to develop the complications that would take you out if they are not already present, so there is little value in trying to get your A1C even below 6.5

There have been a couple of US studies that looked at A1C in older patients including on done by/for the Veterans Administration and their conclusion was:

"Among older individuals with diabetes, intensive glucose control may lead to greater harm than benefit. Although large clinical trials have consistently shown that reducing A1C prevents microvascular complications (e.g., retinopathy and nephropathy) over time, short-term benefits of intensive glucose control in older patients with a longer duration of diabetes have yet to be demonstrated"

So it sounds like your Doc is treating based on the best information/advice out there right now

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A Diabete...

I feel that my primary care Physicians Assistant is following these sort of guidelines. (I am 74, overweight 175 lbs, 5' 2" with Type 2. I do take cholesterol Zetia generic 10 mg & blood pressure Lisinoprill 20 mg medication. But am really healthy for my age I think.) I believe that my A1Cs have been over 7.0 since 2018. She doesn't seem worried and recently said I am nearer to 7.0 since my A1C was down from 7 3 to 7.2 on August 15th. She has not tried to help me find a way to get any of the newer disbetes medications at a lower cost. She say I am too hard on myself.. My Medicare Part D plan doesn't cover any non-generic medications well at all. I am still taking only my Metformin ER & Glipizide ER.
I wonder if a diabetic specialist or internal medical doctor would do better for me? I hate making changes and would need to drive about 20 miles to change to a good specialist. Am I going to damage my eyes & body organs by keeping my BS above 7.0? I am really trying to eat low carb and normally eat between 50 and 75 carbs or less per day.