What is an acceptable HbA1c level in very complex older adults?

In managing diabetes for very complex older adults, an HbA1c level of less than 8.5% is considered acceptable due to several factors unique to this population. Older adults often have multiple comorbidities, potentially leading to a more individualized approach to diabetes management. Striving for more stringent HbA1c goals, such as less than 7% or 7.5%, may increase the risk of hypoglycemia, which can be particularly dangerous in this age group.

Additionally, as people age, their glycemic control may not need to be as strict because the benefits of tight glycemic control may diminish, and factors such as life expectancy, functional status, and quality of life become more significant considerations. Therefore, a target HbA1c level of less than 8.5% acknowledges the complexities faced by very older adults and aligns with recommendations that prioritize overall health and safety over rigid glycemic targets.