Diabetes Mellitus: New Onset in Elderly – What is Optimal HbA1c Level?

MedicalResearch.com Interview with: Dr. Orit Twito

Department of Endocrinology, Hillel Yaffe Medical Center, Hadera, Israel

MedicalResearch.com: What are the main findings of the study?

Answer: An HbA1c level above 7.5% (58mmol/mol) is associated with increased risk for all-cause mortality and with a lower revascularization rate in elderly patient with new onset diabetes mellitus. HbA1c above 8.5 %( 69nmol/mol) was associated with even higher mortality rate, although this difference did not reach statistical significance.

MedicalResearch.com: Were any of the findings unexpected?

Answer: Until the results of our study, evidence on the optimal glycemic control for the sub-group of patients with new-onset diabetes melitus in older age (65 years and above) was absent! As far as we know, this is the first study in the published literature that dealt with this question.

MedicalResearch.com: What should clinicians and patients take away from your report?

Answer: From my point of view there are two main take home messages:

  • The first is that elderly  with new onset DM probably benefit from HbA1c  lower than 7.5%, and maybe even from Hba1c of less than 7%.
  • The other is that we, the clinicians have to treat every diabetic patient differentially, according to his age, gender, ethnicity and duration of disease,

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Answer: Further research is needed to determine the recommended glycemic control target in this unique population.

Citation:

New-Onset Diabetes Mellitus in Elderly Subjects: Association between HbA1c levels, mortality, and coronary revascularization

Diabetes Care. 2013 Jul 22. [Epub ahead of print]

Twito O, Ahron E, Jaffe A, Afek S, Cohen E, Granek-Catarivas M, Klein P, Hermoni D.

Department of Endocrinology, Hillel Yaffe Medical Center, Hadera, Israel.