Brief Commentary: Glycemic Targets for Older Adults With Type 2 Diabetes
Authors: Emily B. Schroeder, Andrew J. Karter
Journal: Annals of Internal Medicine (2018)

Ideas and Opinions21 August 2018Brief Commentary: Glycemic Targets for Older Adults With Type 2 DiabetesCorrection(s) for this article:CorrectionsDec 2018Correction: Glycemic Targets for Older Adults With Type 2 DiabetesFREEEmily B. Schroeder, MD, PhD and Andrew J. Karter, PhDEmily B. Schroeder, MD, PhDKaiser Permanente Colorado and University of Colorado, Aurora, Colorado (E.B.S.) and Andrew J. Karter, PhDKaiser Permanente Northern California, Oakland, California (A.J.K.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-1471 SectionsSupplemental MaterialAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail This article has been corrected. The original version (PDF) is appended to this article as a Supplement.Editors' Note: This commentary was selected for publication from among several submitted in response to a call for readers' perspectives on treatment targets for type 2 diabetes.Most guidelines recommend individualizing glycemic targets for patients with type 2 diabetes in the context of shared decision making (1–4). In general, this strategy weighs the benefits of treatment against such factors as age, life expectancy, disease complexity, functional and cognitive impairments, risk for adverse drug effects, medication burden, and available resources. Despite the aligned goals of ...References1. American Diabetes Association. 6. Glycemic targets: standards of medical care in diabetes-2018. Diabetes Care. 2018;41:S55-S64. [PMID: 29222377] doi:10.2337/dc18-S006 CrossrefMedlineGoogle Scholar2. American Diabetes Association. 11. Older adults: standards of medical care in diabetes-2018. Diabetes Care. 2018;41:S119-S125. [PMID: 29222382] doi:10.2337/dc18-S011 CrossrefMedlineGoogle Scholar3. Conlin PR, Colburn J, Aron D, Pries RM, Tschanz MP, Pogach L. Synopsis of the 2017 U.S. department of veterans Affairs/U.S. department of defense clinical practice guideline: management of type 2 diabetes mellitus. Ann Intern Med. 2017;167:655-663. [PMID: 29059687]. doi:10.7326/M17-1362 LinkGoogle Scholar4. Qaseem A, Wilt TJ, Kansagara D, Horwitch C, Barry MJ, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Hemoglobin A1c targets for glycemic control with pharmacologic therapy for nonpregnant adults with type 2 diabetes mellitus: a guidance statement update from the American College of Physicians. Ann Intern Med. 2018;168:569-576. [PMID: 29507945]. doi:10.7326/M17-0939 LinkGoogle Scholar5. Karter AJ, Warton EM, Lipska KJ, Ralston JD, Moffet HH, Jackson GG, et al. Development and validation of a tool to identify patients with type 2 diabetes at high risk of hypoglycemia-related emergency department or hospital use. JAMA Intern Med. 2017;177:1461-1470. [PMID: 28828479] doi:10.1001/jamainternmed.2017.3844 CrossrefMedlineGoogle Scholar6. Schroeder EB, Xu S, Goodrich GK, Nichols GA, O'Connor PJ, Steiner JF. Predicting the 6-month risk of severe hypoglycemia among adults with diabetes: development and external validation of a prediction model. J Diabetes Complications. 2017;31:1158-1163. [PMID: 28462891] doi:10.1016/j.jdiacomp.2017.04.004 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Kaiser Permanente Colorado and University of Colorado, Aurora, Colorado (E.B.S.)Kaiser Permanente Northern California, Oakland, California (A.J.K.)Grant Support: Dr. Schroeder is supported by grants K23 DK099237 from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and R01 HS022963 from the Agency for Healthcare Research and Quality. Dr. Karter is supported by grants P30 DK092924 and R01 DK103721 from NIDDK, R56 AG051683 from the National Institute on Aging, R01 LM012355 from the National Library of Medicine, and BAA-13-00119 from the U.S. Food and Drug Administration.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-1471.Corresponding Author: Emily B. Schroeder, MD, PhD, Institute for Health Research, Kaiser Permanente Colorado, 2550 South Parker Road, Suite 200, Aurora, CO 80014; e-mail, emily.b.[email protected]org.Current Author Addresses: Dr. Schroeder: Institute for Health Research, Kaiser Permanente Colorado, 2550 South Parker Road, Suite 200, Aurora, CO 80014.Dr. Karter: Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA 94612.Author Contributions: Conception and design: E.B. Schroeder.Drafting of the article: E.B. Schroeder.Critical revision for important intellectual content: E.B. Schroeder, A.J. Karter.Final approval of the article: E.B. Schroeder, A.J. Karter.This article was published at Annals.org on 26 June 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoBrief Commentary: Social Determinants of Health and Treatment Targets for Type 2 Diabetes D.R. Bailey Miles Brief Commentary: Confusing Treatment Guidelines for Patients With Type 2 Diabetes Irl B. Hirsch and Jay S. Skyler Brief Commentary: Laboratory Accuracy of Hemoglobin A1c Ranges and Treatment Targets for Patients With Type 2 Diabetes Brian V. Burke and Sandra Hedin Brief Commentary: The Glycemic Target Guideline Controversy: Same Evidence, Different Perspectives, and a Proposal for Common Ground David C. Aron , Paul R. Conlin , and Leonard Pogach Correction: Glycemic Targets for Older Adults With Type 2 Diabetes Metrics Cited byCurrent concepts and clinical importance of glycemic variabilityGlucose control and cognitive and physical function in adults 80+ years of age with diabetesDelays in anti‐hyperglycaemic therapy initiation and intensification are associated with cardiovascular events, hospitalizations for heart failure and all‐cause mortalityCorrection: Glycemic Targets for Older Adults With Type 2 Diabetes 21 August 2018Volume 169, Issue 4Page: 250-251KeywordsDecision makingDisclosureElderlyHbA1cHypoglycemiaLife expectancyResearch quality assessmentSafetyType 2 diabetesWound healing ePublished: 26 June 2018 Issue Published: 21 August 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...