In general, the blood sugar levels are assessed by two blood tests—one done on an empty stomach and the other which is postprandial, to assess the level of sugar in the bloodstream and also the rate at which the body synthesizes sugar from food sources. However, most diabetologists recommend a further test to assess the diabetes glucose levels thereby, facilitating better sugar management.
The three-monthly HbA1c levels are an important indicator of a person’s sugar management. While in the general treatment of diabetes, it is considered that having as low a HbA1c level is ideal with regard to diabetes glucose levels, research proves that as people age, the HbA1c reading is likely to be a little higher than when we are younger owing to the naturally slowing metabolism of the system. According to the American Geriatrics Society, in people who are 65 and above, who are in reasonably good health, maintenance of a 7 to 7.5 percentage HbA1c is considered a healthy diabetes glucose level. For those who have comorbid factors associated with diabetes with moderate health and fitness, one could target between 7, 5, and 8% on the HbA1c score. For those who have severe health related complications such as cancer or other auto-immune conditions; dementia; Parkinson’s; or any other severe comorbidity associated with high blood sugar levels such as diabetic nephropathy, diabetic neuropathy, renal failure, or cardiac issues, the permitted HbA1c reading may even be as high as 9%.
While a strict dietary regimen and diabetes glucose level control are considered even lifesaving in people above 60 who are in very good health, the same degree of control may be contra-indicated in seniors who already have a poor life expectancy as it may cause them to go into hypoglycemic shock. The reason for this is that as we age, our sensitivity to insulin and other medications for blood sugar management changes.
It is important therefore for diabetologists who specialize in geriatric diabetes to carefully assess the specific needs of their patients concerning the maintenance of optimum diabetes glucose levels and then medicate.