TY - JOUR T1 - Physicians frequently fail to de-intensify treatment in older patients with diabetes and very low haemoglobin A1c or blood pressure JF - Evidence Based Medicine JO - Evid Based Med SP - 158 LP - 158 DO - 10.1136/ebmed-2016-110462 VL - 21 IS - 4 AU - Rozalina McCoy AU - Kasia Lipska Y1 - 2016/08/01 UR - http://ebm.bmj.com/content/21/4/158.abstract N2 - Commentary on: Sussman JB, Kerr EA, Saini SD, et al. Rates of Deintensification of Blood Pressure and Glycemic Medication Treatment Based on Levels of Control and Life Expectancy in Older Patients With Diabetes Mellitus. JAMA Intern Med 2015;175:1942–9OpenUrlCrossRefPubMed.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 … ER -