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Comorbid Illness Reduces Impact of Glucose Control

Age alone not the only predictor of benefits of intensive glucose control

TUESDAY, July 1 (HealthDay News) -- Comorbid illnesses and functional impairments are more important than age alone in predicting the efficacy of intensive glucose control, researchers report in the July 1 issue of the Annals of Internal Medicine.

Elbert S. Huang, M.D., of the University of Chicago, and colleagues modeled the data from major clinical studies in geriatrics and diabetes to understand the impact of comorbid illness and functional status on the benefits of glucose control in a population of patients aged 60 to 80 years with type 2 diabetes and varied life expectancies.

In patients aged 60 to 64 years with good health at baseline and a life expectancy of 14.6 years, glucose control had an expected benefit of 106 quality-adjusted days, whereas those with a life expectancy of 9.7 years gained only 44 quality-adjusted days, and those with a life expectancy of 4.8 years gained only eight quality-adjusted days, the researchers found.

"The challenge for older patients and their providers is in deciding how best to apply results from clinical trials to the care of an individual," the authors write. "These personalized estimates provide a starting point for discussions between older diabetic patients and their providers about the value of pursuing a complex therapy, such as intensive glucose control."

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