Intensive glycemic control in adults aged 80 years and older: A randomized trial evaluating diabetes complications and competing mortality.
Jin-Han Yang, Yun-Kai Yeh, Harn-Shen Chen
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In 30 seconds
This randomized controlled trial evaluated the effects of intensive glycemic control on diabetes complications in adults aged 80 years and older. Participants were assigned to either an intensive target (HbA1c < 7%) or a conservative target (HbA1c < 9%) and followed for 5 years. While the intensive group achieved a lower mean HbA1c (7.42% vs 8.21%; p = 0.005), there was no reduction in microvascular or macrovascular events, and severe hypoglycemia was more common in this group.
Key findings
- Mean HbA1c was significantly lower in the intensive group at 5 years (7.42% vs 8.21%; p = 0.005).
- Intensive therapy did not reduce microvascular events (HR 1.24, 95% CI 0.76-2.04).
- Intensive therapy did not reduce macrovascular events (HR 1.02, 95% CI 0.36-2.92).
- Severe hypoglycemia requiring hospitalization occurred more frequently in the intensive group (7 vs 1 event).
Why it matters
The findings highlight the limited benefits of intensive glycemic control in very old adults with type 2 diabetes, where high competing mortality may overshadow potential advantages. This underscores the need for individualized treatment approaches in this population.