Adjustments for glycemic targets in older adults?

• A. Individualize targets with consideration of hypoglycemia risk; may target A1C <7% or higher depending on comorbidity.
• B. Target A1C <7% for all elderly.
• C. Target A1C <6% regardless of comorbidity.
• D. Avoid any glucose monitoring in elderly.

Answer: (A)

Glycemic targets in older adults should be individualized based on the risk of hypoglycemia and overall health status. Older patients vary greatly—some are healthy and active, others have multiple comorbidities, cognitive or functional limitations, or limited life expectancy. Because of this, a single target like A1C <7% for everyone can do more harm than good by increasing hypoglycemia risk or imposing burdens that don’t meaningfully improve quality of life. The best answer reflects that you may aim for an A1C around 7% in healthier older adults, but a higher target may be appropriate when there are significant comorbidities or high hypoglycemia risk.

Setting targets too aggressively, such as A1C <6% for all older adults, can raise the danger of dangerous hypoglycemia. On the other hand, avoiding glucose monitoring altogether isn’t appropriate because regular monitoring is needed to safely guide treatment and adjust plans as health status changes.