Overtreatment for BP and Glucose Control in Older Diabetic Patients

Although aggressive therapy is recommended to lower glucose levels and blood pressure (BP) in many diabetic patients, recent guidelines recommend less-intensive treatment in older patients. To assess the extent of such treatment “deintensification,” Veterans Affairs researchers identified 211,667 older patients (mean age, 78) who were receiving glucose- or BP-lowering medications other than metformin, angiotensin-converting enzyme inhibitors, or angiotensin-receptor blockers. Patients with glycosylated hemoglobin (HbA_1c) levels that were very low or moderately low (<6% or 6.0%–6.4%, respectively) and those whose BP levels were very low (systolic BP <120 mm Hg) or moderately low (systolic BP 120–129 mm Hg or diastolic BP <65 mm Hg) were cons…