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The goals of diabetes care are to ensure maximal treatment benefit, with the least harm and treatment burden, based on each patient's individual circumstances. Thus, glycemic and blood pressure targets need to be individualised in the context of patient's age, life expectancy and burden of comorbidities. However, in clinical practice, many older patients with diabetes achieve unnecessarily low levels of glucose and blood pressure (BP) control—levels that are unlikely to provide benefit and may actually lead to harm, such as hypoglycaemia, hypotension, falls and medication side effects.1 ,2 Prior studies have not examined whether treatment is de-intensified as part of routine diabetes care when glycemic or BP levels …
Contributors RMcC and KL drafted the manuscript and participated in critical revisions.
Funding National Institute on Ageing, 10.13039/100000049, K23 AG048359, P30 AG21342.
Competing interests KL receives support from the Centers of Medicare & Medicaid Services (CMS) to develop and maintain publicly reported quality measures.
Provenance and peer review Commissioned; internally peer reviewed.