4.0.0.0 TREAT­MENT GOALS

4.1.0.0 Rec­om­men­da­tions

Recommendations

12.5 Older adults who are oth­er­wise healthy with few co­ex­ist­ing chron­ic ill­ness­es and in­tact cog­ni­tive func­tion and func­tion­al sta­tus should have lower glycemic goals (such as A1C <7.5% [58 mmol/‍mol]), while those with mul­ti­ple co­ex­ist­ing chron­ic ill­ness­es, cog­ni­tive im­pair­ment, or func­tion­al de­pen­dence should have less strin­gent glycemic goals (such as A1C <8.0–8.5% [64–69 mmol/‍mol]). C

12.6 Glycemic goals for some older adults might rea­son­ably be re­laxed as part of in­di­vid­u­al­ized care, but hy­per­glycemia lead­ing to symp­toms or risk of acute hy­per­glycemia com­pli­ca­tions should be avoid­ed in all pa­tients. C

12.7 Screen­ing for di­a­betes com­pli­ca­tions should be in­di­vid­u­al­ized in older adults. Par­tic­u­lar at­ten­tion should be paid to com­pli­ca­tions that would lead to func­tion­al im­pair­ment. C

12.8 Treat­ment of hy­per­ten­sion to in­di­vid­u­al­ized tar­get lev­els is in­di­cat­ed in most older adults. C

12.9 Treat­ment of other cardiovas­cu­lar risk fac­tors should be in­di­vid­u­al­ized in older adults con­sid­ering the time frame of benefit. Lipid-‍low­er­ing ther­a­py and as­pirin ther­a­py may benefit those with life ex­pectan­cies at least equal to the time frame of pri­ma­ry pre­vention or sec­ondary in­ter­ven­tion tri­als. E