What's the Optimal HbA_1c Level in Elders?

Experienced clinicians have long recognized that tight glycemic control can be perilous in frail older patients with type 2 diabetes. Now, an observational study addresses that concern. Researchers in San Francisco studied 367 community-dwelling, older patients (mean age, 80) with diabetes who participated in a comprehensive adult day-care program and were unable to live independently. Glycosylated hemoglobin (HbA_1c) levels were measured at baseline, and functional decline and death were tracked during 2 years of follow-up (during which, average HbA_1c levels didn't change much).

Analyses were adjusted for potentially confounding variables. Compared with patients in the reference category (HbA_1c levels, 7%–8%), patients whose HbA_1c levels wer…