Overtreatment still a huge problem among older adults with Type II diabetes

We’ve known about the dangers of pushing blood sugar too low in older people with Type II diabetes for at least 10 years. But a new study conducted by researchers with the prestigious Mayo Clinic recently found that it’s STILL happening in medical practices across the country.

I’ll tell you more about that eye-opening study in a moment. But first, let’s back up to consider the bigger picture about blood sugar…

Lower doesn’t always mean better when it comes to blood sugar

Once upon a time, mainstream doctors thought the lower the better when it came to blood sugar in their patients with Type II diabetes.

But we now know that setting overly strict blood sugar targets in the elderly offers very few benefits. Furthermore, it can actually cause three major harms…

First of all, pushing blood sugar too low can, of course, cause hypoglycemia (low blood sugar), which research links with cognitive impairments, cardiovascular events, falls, fainting, fractures, reduced quality of life, and higher mortality risk.

Second, low blood sugar is a leading cause of emergency department visits 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  blood sugar, or just being stuck in the hospital in general.)

Third, insulin and the terrible, new, “insulin-like” drugs can cause serious side effects in addition to those just mentioned. In fact, we know they can cause heart disease and even a terrible, deadly type of gangrene.

Escaping the blood sugar merry-go-round

Almost 10 years ago, the evidence against overly strict blood sugar control reached a tipping point. Some agencies even began to favor less-stringent targets for people older than 65 years, including the American Diabetes Association (ADA), the American Geriatrics Society, the U.S. Departments of Defense, and the Veterans Affairs Administration. Some even began to caution specifically against using insulin and sulfonylurea drugs in older patients.

Furthermore, many national and international treatment guidelines for blood sugar were revised. Now, many recommend aiming to reduce Hemoglobin A1C (HbA1c), the long-term measure of blood sugar, to less than 7.5 percent in healthy older adults and to less than 8.5 percent in the frail elderly.

And in theory, that should be the end of the story.

Yet, even now, 10 years later, we still see far too much overtreatment in older patients with Type II diabetes…

Overtreatment persists, despite known harms

I actually had a personal experience not long ago with someone who had recently been hospitalized for a stroke, who had also been diagnosed with Type II diabetes. The hospital doctor she saw wanted to immediately prescribe her metformin AND a second, new, dangerous, expensive, and injectable insulin drug—at $1,700 per month, with no regard to cost or consequences.

But I let her know about the real research on this terrible new drug (beyond the sales hands-out from the pharma rep).

So, then, she talked to a second hospital doctor to voice her concerns. And she agreed to prescribe metformin and a second, oral drug that had been around for a while, rather than the newer, injectable insulin drug.

But, lo and behold, within three days, the two combined oral drugs had already led to dangerously low blood sugar. At that point, she was able to get to see her regular internal medicine doctor of many years. He discontinued the second drug and stayed with just metformin. (Although really, as I’ve written about before, there are many nutritional and natural approaches to help manage healthy blood sugar, without resorting to drugs.)

When all is said and done, it’s easy to criticize these hospital doctors. But truthfully—they just don’t have time to research the science all day, as I do.

Instead, they’re completely overwhelmed during a regular day just seeing patients. The healthcare insurance industry keeps squeezing more and more patients into an hour, without real regard for their actual health.

Now, back to the new study I mentioned earlier…

Study finds overtreatment still a problem

For this new study, researchers with the Mayo Clinic analyzed data for nearly 200,000 adults with Type II diabetes. They looked at the participants’ HbA1c levels and use of insulin or sulfonylurea drugs (both of which can lead to low blood sugar).

They also looked at whether participants had 16 different conditions that the ADA says should prompt consideration of less-aggressive treatment.

For example, the ADA says people with Type II diabetes who also have a history of any of these conditions should have more relaxed blood sugar targets:

  • Cancer
  • Dementia
  • Eye diseases
  • Heart disease
  • High blood pressure
  • Kidney diseases
  • Stroke

 The reason why people with these conditions shouldn’t push their blood sugar too low is pretty straight-forward…

Starving damaged organs and tissues by excessively reducing blood glucose (energy) into these organs and tissues harms these patients (and their damaged organs) even further.

Well, it turns out, 45 percent of the study participants had one of these conditions and therefore met the criteria for reduced treatment. In addition, another 30 percent of patients had diabetes and another chronic disease (not on the list above), such as arthritis, depression, COPD, liver disease, or urinary disorders.

Lastly, 13 percent of patients had life-threatening diseases, such as cancer, advanced dementia, or kidney failure. And mainstream diabetes drug treatments in these patients is particularly pointless and dangerous.

Yet when the researchers moved on to compare this data to the participants’ HbA1C levels, they found something startling…

The youngest patients (ages 18 to 44  years), with the most to gain from stricter blood sugar control had the highest HbA1C levels. Their average level was 7.7 percent.

On the other hand, the oldest patients (75 or older), with the most to lose from stricter blood sugar control, had the lowest HbA1C levels. Their average level was 6.9 percent.

These results are exactly backwards of what they should have been—putting all the participants at risk! The younger patients, who should achieve lower blood sugar, aren’t meeting that target. And the older patients, for whom low blood sugar is a real danger, are getting their levels pushed too low!

Make sure your doctor doesn’t try to push your numbers too low

In the end, the science shows that slightly elevated blood sugar (like slightly elevated blood pressure) may be naturally protective in older adults. So, if you have Type II diabetes, I urge you to find a doctor who’s on top of the latest science and who will adjust and personalize your treatment based on your age.

Plus, there’s a ton of emerging research showing you can prevent—and even reverse—Type II diabetes without resorting to drugs. You can obtain all the details about the uncommonly effective, commonsense strategies to do so in my online learning protocol, the Integrative Protocol for Defeating Diabetes. To learn more, or to enroll today, click here now.


“Paradox of glycemic management: multimorbidity, glycemic control, and high-risk medication use among adults with diabetes.” British Medical Journal Open Diabetes Research & Care, 2020;8:e001007. doi.org/10.1136/bmjdrc-2019-001007