Question of the Week | Older Adults & Goals for Care
TS is 82 years old, living with type 1 diabetes for the past 56 years. They present to the clinic with their family for diabetes care and education. TS’s last A1C was 7.6%, with a Time in the Range of 64% and Time below the Range of 1%. TS lives alone and self-manages their medications, and the family reports concern of potential missed insulin doses and dietary intake patterns are less consistent over the past few months.
Considering diabetes management in older adults, what recommendations would you give TS and his family?
- TS’s A1C is not at target of less than 7%, recommend behavior modification and work to improve medication adherence.
- A1c targets need to be liberalized to less than 8% for all older adults to reduce hypoglycemia risk.
- Assess TS’s comorbidities, cognitive function, and life expectancy before providing additional recommendations
- Recommend increased family involvement in TS’s daily diabetes medication management due to missed insulin doses and change in diet intake.
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