August 6, 2013

Dramatic Results When Treatment Tailored for Elderly

See what happens when the elderly are the only group in a study? This proves that the elderly should not be excluded from research studies and that they may be successful in managing their diabetes. This study was done in the United Kingdom, but provides a great example of what is necessary and may be accomplished by the people over the age of 70. Can the feeble minds at our leading research facilities wrap their heads around this study and end the discrimination against the elderly?

All patients were over the age of 70, and were included in the trial because their GP (general practitioner) thought they needed more medication. Oh really, doctor, elderly patients need more medication and it is your job to over medicate them? The findings were stark because those patients who were given the drug were three times more likely to reach their target than those who were not involved in the study, and received standard treatment. But researchers were particularly excited by the result from the placebo group, in which 27 percent met their targets without any medication.

This shows what can happen when great studies are undertaken for the benefit of the elderly. Presently, patients over the age of 70 are treated using a blanket method of aggressively reducing blood glucose levels, but that does little to take their complex needs into account.

Dr. David Strain, from the University of Exeter Medical School, who led the study, said: "People over the age of 70 are more likely to have multiple complications, such as heart disease, as well as type 2 diabetes. Yet perversely, these patients have so far been excluded from clinical trials, precisely because of these complications. It means they are generally treated with a 'one-size-fits-all' approach. We found that simply by individualizing goals and setting realistic targets, then spending time talking to patients rather than aggressively chasing targets resulted in nearly a quarter of patients achieving better glycemic control, without the need for medication."

Dr. Strain said: "This was a small trial, but the results were quite dramatic, and it is the first strong evidence that individualized care can make a huge difference to the lives of older patients with type 2 diabetes. We now need to build on this evidence with further research."

Yes, further research may be required for the dense American researchers to understand what their discrimination is doing to the lives of the elderly that are in essence just being written off and given the one-size-fits-all treatment. It may be even possible to reduce the medical costs and give pride back to the elderly population.

The points that are unclear to me that could be disconcerting are the A1c's at the start of the study and what the individual targets became during the study. If they are above 9.0% and the lower targets were still above 7.5%, then there may be some other concerns about individualizing treatments.

I had written and asked for a copy of the study, but none was forthcoming. This is a shame. I sincerely hope that the USA researchers learn from this study and don't continue to stick their nose in the air. Someone may flatten it for them.

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