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Older adults are at excess risk for adverse events from antidiabetes medications and have less time to benefit from tight glycemic control. Accordingly, the American Diabetes Association (ADA) has relaxed glycemic targets for older patients (Diabetes Care 2022; 45[Suppl 1]:S83). Currently, glycosylated hemoglobin (HbA1c) targets are <7.5% for relatively healthy older adults, <8% for those with multiple chronic illnesses, and avoidance of symptomatic hyperglycemia (but no specific target) for those in very poor health. Additionally, the ADA states that “glycemic goals for some older adults might reasonably be relaxed as part of individualized care.”
To assess whether clinical practice aligned with evolving guidelines between 2001 and 2018, re…