Diabetes, Heart, and Cardiovascular Diseases News Chronicle.      Article 269

Deintensification Of Diabetic Therapy For Elderly People To Avoid Hypoglycemia

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A study shows a serious health complication such as hypoglycemia with an intensive control of blood sugar levels (a tight glycemic control or overtreated diabetes) among older adults, aged more than 75 years who are under the Medicare and Medicaid programs.

Deintensification of diabetic therapy among the elderly to avoid hypoglycemia or low blood sugar (glucose) levels.

The researchers have used 78,792 records of old age people (aged more than 65 years) from Medicare. The study shows nearly 11 percent of patients of diabetes had a very low level of blood sugar (glucose) (hypoglycemia), which shows that they are taking more drugs to control diabetes. They also found that just 14 percent of the patients who are taking more drugs to control diabetes have tried to reduce their medications for the prevention of hypoglycemia in the next six months.

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Generally, the level of treatment may change in patients of diabetes as per their goal. One can say that an individual is receiving too much medication to control their high blood sugar (glucose) levels (diabetes) if the HbA1c is less than 6.5 percent or experiencing frequent episodes of hypoglycemia.

The deintensification of medication (the management of blood glucose levels to be less intensive) was suggested by the researchers for frequent outpatients or people living in urban areas with more than six chronic conditions.

Health experts say that there is no method to find out whether an individual is under intensive diabetes treatment (being overtreated) or not.

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They say that an aggressive treatment to control blood sugar (glucose) levels (glycemic control) should not be recommended to an old aged individual with other serious health conditions. This is because the benefits of intensive diabetes management will be known only after many years.

The older individuals are less likely to get the benefits of aggressive treatment to control blood glucose levels. The side effects of low blood sugar levels (or hypoglycemia ) are falling, dizzy spells, fainting, confusion and even death. Instead, they should focus on good blood sugar control so that they may not experience high blood sugar levels (or hypoglycemia ).

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Healthy young patients with diabetes should work for aggressive diabetes treatment. The benefits are less and harms are more with an aggressive diabetes treatment of glycemic control among older people. But an uncontrolled blood sugar (glucose) levels may also be dangerous.

The lead author of the study was professor Matthew Maciejewski, Ph.D., Duke University, a private research university, Durham, North Carolina. The co-authors of the study are Dr. Eve Kerr and Dr. Jeremy Sussman, from the University of Michigan, United States. The study was published on September 13, 2017, in the Journal of General Internal Medicine. Title of the article was "Overtreatment and Deintensification of Diabetic Therapy among Medicare Beneficiaries."
DOI: dx.doi.org/10.1007/s11606-017-4167-y

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Early β-lactam Or Macrolide Antibiotics Use Was Not Linked With Celiac Disease Or Type 1 Diabetes


A study at the University of Florida shows no association between the development of type 1 diabetes (T1D) or celiac disease (CD) and the early use of β-lactam or macrolide antibiotics.

β-Lactam Macrolide Antibiotics use in the children was not linked to celiac disease and type 1 diabetes.

Researchers reviewed the health of those children who are at the high genetic risk of the development of type 1 diabetes (T1D) and have used antibiotic drugs during their first four years of life. The researchers reviewed the health records of 8,495 children from four countries.

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Researchers did not find any association in the development of autoimmune diseases such as type 1 diabetes (T1D) or celiac disease (CD) with the use of antibiotics. The following are the most common antibiotics found to be used on the children: amoxicillin, penicillins, cephalosporins and macrolides.

Researchers say that antibiotic drugs can be recommended to children who are at the high genetic risk of type 1 diabetes (T1D) if the doctor believes that the antibiotic drug is required for the disease treatment of the child. The study results show no adverse effects on the gut bacteria in young children with the use of antibiotics.

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But the researchers suspect that the use of antibiotics on young children may increase the risk of viral infections and will affect the gut bacteria.

The study was published on October 9, 2017, in the JAMA Pediatrics. Title of the article was "Association Between Early-Life Antibiotic Use and the Risk of Islet or Celiac Disease Autoimmunity."
DOI: doi.org/10.1001/jamapediatrics.2017.2905

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Published on November 23, 2017


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