More than 60% of people aged older than 65 years may be missing clinical targets set by the American Diabetes Association (ADA) for the management of their diabetes, according to a study published in the July issue of Diabetes Care.


Senior author Elizabeth Selvin, PhD, MPH, and fellow investigators evaluated levels of hemoglobin A1C, blood pressure, and low-density lipoprotein (LDL) cholesterol among 5,018 participants aged 67 years to 90 years (1,574 with and 3,444 without diabetes). The ADA recommends that patients with diabetes maintain levels of hemoglobin A1C below 7%, blood pressure less than 140/90 mmHg, and LDL cholesterol lower than 100 mg/dL. Dr. Selvin and colleagues found that 72% of their subjects were on target with their hemoglobin A1C levels, 73% for blood pressure goals, and 63% for LDL cholesterol levels, but only 35% met all three targets. 


When the researchers applied less stringent targets that have been suggested for older adults (hemoglobin A1C, <8%; blood pressure, <150/90 mmHg; LDL cholesterol, <130 mg/dL), 68% of the group met all three targets. Specifically, 90% were on target for hemoglobin A1C, 87% for blood pressure, and 86% for cholesterol.


The researchers also found racial disparities, primarily in women, even when factors such as levels of income and education were taken into account. White women in the study were 58% more likely than black women to have acceptable levels of hemoglobin A1C, blood pressure, and LDL cholesterol.