New study spotlights dangers of aggressive blood sugar control

Last month, I told you about an article that posed the question: Should doctors de-prescribe diabetes drugs in the elderly?

My short answer?

Yes — absolutely.

To defend my standpoint, I cited evidence showing that aggressive blood sugar control in the elderly causes serious problems. And now, a brand-new study published in the journal Diabetes, Obesity & Metabolism backs up my argument…

In this new Dutch analysis, researchers found that a staggering percentage of elderly patients with Type II diabetes are over-treated, resulting in dangerous health consequences.

In my view, every primary care doctor and endocrinologist in the country should know about this important study. But, as the Dutch researchers noted, most primary care physicians don’t seem to have a clue about the latest research. (And as I’ve mentioned many times before, an alarmingly large number of physicians and specialists don’t even attempt to keep abreast of the breakthroughs in their field.) Instead, they just keep over-medicating their patients.

I’ll tell you about all the results of that eye-opening study in a moment. But first, let’s back up…

When blood sugar goes too low, it spells trouble

Many older patients in the U.S. and Canada with Type II diabetes are treated with drugs to reduce their Hemoglobin A1C (HbA1C), the long-term measure of blood sugar control, to less than 7.0 percent.

And I’ve been warning about the dangers of this overly aggressive target for a long time. Especially in older adults. (You can read about the three goals Type II diabetes treatment should actually be aiming to accomplish here.)

That’s because newer clinical trials show that achieving this stringent HbA1C target doesn’t improve mortality from heart disease. Nor does it improve overall mortality — which should be the bottom line for all treatments.

Plus, evidence shows that achieving this strict target actually increases the risk of episodes of low blood sugar, especially in older people. And research links low blood sugar with cognitive impairments, cardiovascular events, fractures, reduced quality of life, and higher mortality risk.

Furthermore, just one episode of low blood sugar can be fatal…

In fact, low blood sugar is a leading cause of emergency department visits to the hospital in older adults in the U.S. Plus, if you’re hospitalized for low blood sugar, you have a very poor prognosis. (Whether due to the episode of blood sugar, or just being stuck in the hospital, which can put you at risk for a hospital-acquired infection and/or medical mistakes.)

By comparison, high blood sugar is a long-term risk factor for chronic diseases of the heart, eyes, kidneys, and peripheral nerves. But there’s little immediate risk to an episode of high blood sugar in Type II diabetes.

About five years ago, some agencies began to favor less-stringent targets for people older than 65 years. And many national and international treatment guidelines even now recommend loosening HbA1C targets to less than 7.5 percent in healthy older adults. And to less than 8.5 percent in the frail elderly.

So now — back to the Dutch study.

For that study, researchers analyzed medical records of 1,002 patients with Type II diabetes — including 319 patients ages 70 and older. The researchers looked specifically at HbA1C levels.

Overall, the researchers found that 20 percent of all patients were over-treated. Worse yet, almost 40 percent of patients ages 70 were over-treated. Plus, these over-treated older patients had a significantly higher complications rate and were described as “frailer” than those with higher HbA1C levels. Furthermore, 20 percent of the over-medicated older patients suffered from low blood sugar events, which led to ER visits and falls.

Astoundingly, the doctors did not adjust the patients’ drug dosages, even after reports of hypoglycemia or falls.

It boggles the mind, really. Even according to the standards of the American Diabetes Association, these patients were being over-treated. And just earlier this month, the American College of Physicians issued new guidelines loosening the HbA1C levels to between 7.0 and 8.0 for most people.

Escaping the blood sugar merry-go-round

So, what can you do?

As I always say, Type II diabetes is just too serious of a disease to go it alone. So, you should always work with a trusted physician who’s caught up on the current science and knows about the serious dangers of over-medicating.

I also have a few other bits of advice:

1. Talk to your doctor about your HbA1C levels
Make sure your doctor monitors your HbA1C levels carefully, especially if you ever experience bouts of dizziness or low blood sugar. If you’re being treated to manage blood sugar, your primary care physician will typically want to see you every four months or so to monitor your level of Hemoglobin A1C.

2. Follow a balanced diet
People with and without Type II diabetes should follow the same balanced diet that includes meat, fish, seafood, dairy, nuts, and vegetables. And despite what you’ve heard, don’t shy away from fruit. You should strive to get two to three servings of fresh fruit a day. The good news is, you can even enjoy 100 percent fruit juice, as I explained in yesterday’s Daily Dispatch.

3. Use metformin only
I never advise using any drug other than metformin, which derived from an ancient European folk remedy called French lilac. This wonder “drug” has been shown to be a safe and effective treatment option for a majority of diabetes patients, with little-to-no side effects.

4. Supplement wisely
Modern science shows that many natural supplements help reduce blood sugar and manage Type II diabetes. In fact, in January, I told you about a potent compound derived from an ancient, golden spice that improves the body’s response to sugar even better than metformin!

5. Do your homework
There are a multitude of drug-free strategies available to manage your diabetes. And many are just a matter of making simple modifications to your lifestyle.

It’s up to you to put in the research. The more knowledge you have about alternative options available to you, the more improved your quality of life will be while managing Type II diabetes.

You can find step-by-step guidance on all these natural approaches for preventing and reversing Type II diabetes in my online learning protocol, the Integrative Protocol for Defeating Diabetes. Simply click here to learn more or to enroll today.


1. “Overtreatment of older patients with type 2 diabetes mellitus in primary care,”
Diabetes, Obesity and Metabolism, January 24, 2018