Deintensification of diabetic therapy in elders to avoid hypoglycemia events leading to dizzy spells, fainting, confusion, falling and even death
A study shows serious health complications such as hypoglycemia with intensive measures to control blood sugar levels (a tight glycemic control or overtreated diabetes) among older adults, aged more than 75 years who are under Medicare and Medicaid programs.
In a study using 78,792 old age people Medicare records, aged more than 65 years, the study results show nearly 11 percent of the diabetic people had very low blood glucose levels (hypoglycemia) indicating they are under overtreatment. They also found that just 14 percent of those people have reduced their blood sugar medications in the next six months.
Generally, overtreatment levels may change among individuals according to an individual goal. One can say an individual is receiving too much medication to control their diabetes or high blood glucose levels if the HbA1c reading is less than 6.5 percent or experiencing frequent hypoglycemia events. They suggest deintensification (blood glucose levels management process to be less intensive) among frequent outpatient visitors or people living in urban places with more than six chronic conditions.
Health experts say there is no method to know whether an individual is under intensive diabetes treatment (being overtreated) or not. They say aggressive procedures to control glycemic or blood glucose levels should not be recommended to an older individual with other serious health conditions. This is because benefits with intensive diabetes management will be known only after many years. Older individuals are less likely to get the benefits of overtreatment of blood glucose levels. Side effects of low blood sugar levels or hypoglycemia conditions are dizzy spells, fainting, confusion, falling and even death. Instead, they should focus on good sugar levels control so that they may not experience high blood sugar levels or hypoglycemia condition. Benefits are less and harms are more with the overtreatment of glycemic control among older people. Undertreatment of blood glucose levels is dangerous. But healthy young patients with diabetes should work for aggressive diabetes treatment.
Lead authors of the study were professor Matthew Maciejewski, Ph.D., Duke University, a private research university, Durham, North Carolina. Co-authors of the study are Dr. Eve Kerr and Dr. Jeremy Sussman, from the University of Michigan, United States. The study findings were 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."
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Early β-lactam or macrolide antibiotics use was not linked with celiac disease or type 1 diabetes
A study by researchers at the University of Florida shows no association between the development of type 1 diabetes (T1D) or celiac disease (CD) and the early usage of β-lactam or macrolide antibiotics.
Researchers reviewed the health of those children who are at high genetic risk of the development of type 1 diabetes (T1D) and used antibiotic drugs during their first four years of life. The number of health records of the children reviewed was 8,495 belonging to four countries. Researchers did not observe any association in the development of autoimmune diseases such as type 1 diabetes (T1D) or celiac disease (CD) with the usage of antibiotics. The most common antibiotics found to be used in the children's treatment were amoxicillin, penicillins, cephalosporins and macrolides.
Researchers say antibiotic drugs can be recommended to children who are at high genetic risk of the development of type 1 diabetes (T1D) if the doctor believes antibiotic drug required to treat a child's disease. The study results show no adverse effects on gut bacteria in young children with the use of antibiotics. But researchers suspect that gut bacteria and viral infections will be effected in young children with the use of antibiotics.
The study findings were 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."
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Published by Jammi Vasista, Chennai, India.