In older adults with diabetes, what is recommended for glycemic management?

• A. Promote use of medication rather than dietary restriction for blood glucose control.
• B. Strict dietary restriction to achieve A1C below 7%.
• C. Avoid all carbohydrates.
• D. Set A1C goal below 5.5%.

Answer: (A)

In older adults, glycemic management should be safe, practical, and nutrition-supportive. Extreme dietary restriction is not advisable because it can lead to undernutrition and frailty, and it often fails to provide stable glucose control given age-related changes and comorbidities. The preferred approach is to use medications to help manage blood glucose while allowing a normal, nutrient-dense diet and regular meals, so energy and protein needs are met and the risk of hypoglycemia is minimized. Targets for blood glucose or glycemic control are individualized and typically not set to be excessively stringent in frail or multimorbid patients. So focusing on pharmacologic management to achieve safe glucose levels, alongside appropriate nutrition, best supports health and function in older adults.