Health
Why Older People May Not Need to Watch Blood Sugar So Closely
By now, Ora Larson recognizes what’s happening. “It feels like you’re shaking inside,” she said. “I’m speeded up. I’m anxious.” If someone asks whether she would like a salad for lunch, she doesn’t know how to respond.
She has had several such episodes this year, and they seem to be coming more frequently.
“She stares and gets a gray color and then she gets confused,” her daughter, Susan Larson, 61, said. “It’s really scary.”
Hypoglycemia occurs when levels of blood sugar, or glucose, fall too low; a reading below 70 milligrams per deciliter is an accepted definition. It can afflict anyone using glucose-lowering medications to control the condition.
But it occurs more frequently at advanced ages. “If you’ve been a diabetic for years, it’s likely you’ve experienced an episode,” said Dr. Sei Lee, a geriatrician at the University of California, San Francisco, who researches diabetes in older adults.
The elder Ms. Larson, 85, has had Type 2 diabetes for decades. Now her endocrinologist and her primary care doctor worry that hypoglycemia may cause falls, broken bones, heart arrhythmias and cognitive damage.
Both have advised her to let her hemoglobin A1c, a measure of average blood glucose over several months, rise past 7 percent. “They say, ‘Don’t worry too much about the highs — we want to prevent the lows,’” the younger Ms. Larson said.
But her mother has spent 35 years working to maintain an A1c below 7 percent — a common recommendation, the goal people sing and dance about in pharma commercials.
She faithfully injects her prescribed drug, Victoza, about three times a week and watches her diet. She’s the oldest member of the Aqua for Arthritis class at a local pool in St. Paul, Minn.
So when her doctors recommended a higher A1c, she resisted. “I think it’s a bunch of hooey,” she said. “It didn’t make sense to me.”
“She got a lot of encouragement and recognition from her physicians for controlling her diabetes, staying on top of it,” her daughter explained. “They always praised her ‘tight control.’”
“For someone who’s been so compliant all these years, it’s like they changed the rules.”
In fact, they have.
More than a decade ago, the American Geriatrics Society called for a hemoglobin A1c of 7.5 to 8 for most older adults with diabetes, and 8 to 9 percent for those contending with multiple chronic illnesses and limited life expectancy. (The elder Ms. Larson has multiple sclerosis and hypertension.)
Other medical societies and advocacy groups, including the American Diabetes Association and the Endocrine Society, have also revised their guidelines upward for older patients.
Relaxing aggressive treatment can involve stopping a drug, lowering a dose or switching to another medication — an approach called de-intensification.
The advent of effective new diabetes drugs — GLP-1 receptor agonists (like Ozempic) and SGLT2 inhibitors (like Jardiance) — has further altered the landscape. Some patients can substitute these safer medications for risky older ones.
But the new drugs can also complicate decisions, because not all older patients can switch — and for those who can, insurance companies may balk at the new medications’ high price tags and deny coverage.
So de-intensification is proceeding, but too gradually.
A 2021 study of Medicare beneficiaries with diabetes, for instance, looked at patients who had gone to an emergency room or been hospitalized because of hypoglycemia. Fewer than half had their medication regimens de-intensified within 100 days.
“Nursing-home residents are the ones that get into trouble,” said Dr. Joseph Ouslander, a geriatrician at Florida Atlantic University and the editor in chief of The Journal of the American Geriatrics Society.
Another 2021 study, of Ontario nursing homes, found that over half of residents taking drugs for Type 2 diabetes had A1c levels below 7 percent. Those with the greatest cognitive impairment were being treated most aggressively.
Dr. Ouslander has calculated, based on a national study, that roughly 40,000 emergency room visits annually resulted from overtreatment of diabetes in older adults from 2007 to 2011. He thinks the numbers are likely to be much higher now.
A brief primer: Diabetes can cause such grievous complications — heart attacks, stroke, vision and hearing loss, chronic kidney disease, amputations — that so-called strict glycemic control makes sense in young adulthood and middle age.
But tight control, like every medical treatment, involves a period of time before paying off in improved health. With diabetes, it’s a long time, probably eight to 10 years.
Older people already contending with a variety of health problems may not live long enough to benefit from tight control any longer. “It was really important when you were 50,” said Dr. Lee. “Now, it’s less important.”
Older diabetics don’t always welcome this news. “I thought they’d be happy,” Dr. Lee said, but they push back. “It’s almost like I’m trying to take something away from them,” he added.
The risk that tight control will also set off hypoglycemia increases as patients age.
It can make people sweaty, panicky, fatigued. When hypoglycemia is severe, “people can lose consciousness,” said Dr. Scott Pilla, an internist and diabetes researcher at Johns Hopkins. “They can become confused. If they’re driving, they could have an accident.”
Even milder hypoglycemic events “can become a quality-of-life issue if they’re happening frequently,” causing anxiety in patients and possibly leading them to limit their activities, he added.
Experts point to two kinds of older drugs particularly implicated in hypoglycemia: insulin and sulfonylureas like glyburide, glipizide and glimepiride.
For people with Type 1 diabetes, whose bodies cannot produce insulin, injections of the hormone remain essential. But the medication is “widely recognized as a dangerous drug” because of its hypoglycemia risk and should be carefully monitored, Dr. Lee said.
The sulfonylureas, he added, “are becoming less and less used” because, while less risky than insulin, they also cause hypoglycemia.
The great majority of older adults with diabetes have Type 2, which gives them more options. They can supplement the commonly prescribed drug metformin with the newer GLP-1 and SGLT2 drugs, which also have cardiac and kidney benefits. If necessary, they can add insulin to their regimens.
Among the new drugs’ more popular consequences, however, is weight loss.
“For older people, if they’re frail and not very active, we don’t want them losing weight,” Dr. Pilla pointed out. And both metformin and the GLP-1 and SGLT-2 medications can have gastrointestinal or genitourinary side effects.
For 15 years, Dan Marsh, 69, an accountant in Media, Pa., has treated his Type 2 diabetes by injecting two forms of insulin daily. When he takes too much, he said, he wakes up at night with “the damn lows,” and needs to eat and take glucose tablets.
Yet his A1c remains high, and last year doctors amputated part of a toe. Because he takes many other medications for a variety of conditions, he and his doctor have decided not to try different diabetes drugs.
“I know there’s other stuff, but we haven’t gone that way,” Mr. Marsh said.
With all the new options, including continuous glucose monitors, “figuring out the optimal treatment is becoming more and more difficult,” Dr. Pilla said.
Bottom line, though, “older people overestimate the benefit of blood-sugar lowering and underestimate the risk of their medications,” he said. Often, their doctors haven’t explained how the trade-offs shift with older age and accumulating health problems.
Ora Larson, who carries chewable glucose tablets with her in case of hypoglycemia (fruit juice and candy bars are also popular antidotes), intends to talk over her diabetes treatment with her doctors.
It’s a good idea. “The biggest risk factor for severe hypoglycemia is having had hypoglycemia before,” Dr. Lee said.
“If you have one episode, it should be thought of as a warning signal. It’s incumbent on your doctor to figure out, Why did this happen? What can we do so your blood sugar doesn’t go dangerously low?”
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Former U.S. Sen. Ben Sasse of Nebraska announced this week that he has been diagnosed with metastatic stage 4 pancreatic cancer, calling the disease “a death sentence” in a message posted on X.
Sasse, 53, said the cancer has spread and acknowledged that he has “less time than I’d prefer,” although he also mentioned recent scientific advances and his intention to pursue treatment.
“I’m not going down without a fight,” Sasse said when revealing his diagnosis. “One sub-part of God’s grace is found in the jaw-dropping advances science has made the past few years in immunotherapy and more.”
HIDDEN FACTOR IN CANCER TREATMENT TIMING MAY AFFECT SURVIVAL, RESEARCHERS SAY
Pancreatic cancer is known to be one of the deadliest forms of cancer, with ongoing research efforts aiming to improve outcomes.
Below are six key things to know about the disease.
No. 1: Pancreatic cancer is often diagnosed late and is highly deadly
Pancreatic cancer is notoriously aggressive and difficult to treat, according to the American Cancer Society. Most patients are not diagnosed until the disease has already spread to other organs, largely because there aren’t reliable screening tests and early symptoms can be vague or absent.
Ben Sasse, a former U.S. senator from Nebraska, announced that he has been diagnosed with metastatic stage 4 pancreatic cancer. (Getty Images; iStock)
The ACS estimates that 67,440 Americans will be diagnosed with pancreatic cancer in 2025, and about 51,980 are expected to die from it. The tumor’s biology creates physical and chemical barriers that reduce the effectiveness of many traditional treatments.
No. 2: New immunotherapies are showing early promise
Researchers at UCLA recently reported progress on an experimental, off-the-shelf, cell-based immunotherapy designed to attack pancreatic cancer.
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In mouse studies, the therapy slowed tumor growth, extended survival and remained effective even after the cancer had spread to other organs, such as the liver and lungs.
The treatment uses special immune cells called natural killer T (NKT) cells, which are genetically modified so they can specifically recognize and attack pancreatic cancer cells.
Early research is exploring new approaches to pancreatic cancer, including experimental immunotherapies and studies of risk factors, but many findings are still in preclinical or observational stages. (iStock)
Unlike personalized therapies, the NKT cells are naturally compatible with different immune systems and can be mass-produced from donor stem cells.
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Researchers estimate that one donor could supply cells for thousands of treatments, with a potential cost of around $5,000 per dose. All testing so far has been done in mice, and human trials have not yet begun.
No. 3: Diet and gut health may affect treatment recovery
Separate research from the Massachusetts Institute of Technology has suggested that the amino acid cysteine could help the gut heal after cancer treatments, such as chemotherapy and radiation.
In mouse studies, cysteine — found in foods like meat, eggs, dairy products, legumes and nuts — helped to regenerate intestinal stem cells that are often damaged during cancer therapy.
Researchers are studying how diet, including nutrients such as cysteine found in high-protein foods, may help support recovery from pancreatic cancer treatments. (iStock)
Additional unpublished research showed benefits after treatment with 5-fluorouracil, a chemotherapy drug used for colon and pancreatic cancers.
Researchers emphasized that human studies are still needed and that cysteine is not a cure for cancer itself.
No. 4: Alcohol and lifestyle factors may raise cancer risk
Recent research published in PLOS Medicine by the International Agency for Research on Cancer found that alcohol consumption is associated with an increased risk of pancreatic cancer.
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The study followed 2.5 million people for about 16 years, finding that each additional 10 grams of ethanol consumed per day was linked to a 3% increase in risk. Higher intake levels were associated with greater risk, particularly with beer and spirits.
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Researchers noted that the study was observational and that more work is needed to understand lifetime drinking patterns.
No. 5: Symptoms are often subtle and easily missed
When symptoms do occur, they can include abdominal pain that spreads to the sides or back, loss of appetite and unexplained weight loss, according to Mayo Clinic.
Some patients develop jaundice — yellowing of the skin and whites of the eyes — along with light-colored or floating stools, dark urine and itching.
Common warning signs of pancreatic cancer can include abdominal pain, unexplained weight loss and loss of appetite. (iStock)
Other possible signs include a new diagnosis of diabetes (or diabetes that becomes harder to control), pain and swelling in an arm or leg that may be linked to a blood clot, and persistent tiredness or weakness.
Those who are experiencing symptoms should consult with a healthcare professional.
No. 6: Age, genetics and health conditions can raise risk
Pancreatic cancer risk is influenced by a combination of genetic, medical and lifestyle factors.
The disease becomes more likely with age, and men are slightly more susceptible, according to the ACS. Those with a family history or inherited genetic mutation also have a higher risk, as do people with type 2 diabetes, obesity and lack of physical activity.
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Diets high in processed or red meats and low in fruits and vegetables, as well as high alcohol consumption, may also contribute to pancreatic cancer risk, along with some occupational chemical exposures, per multiple cancer agencies.
Experts note, however, that many people are diagnosed with the disease despite having no clear risk factors.
Deirdre Bardolf, Ashley J. DiMella, Alex Nitzberg and Angelica Stabile, all of Fox News Digital, contributed reporting.
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The first oral GLP-1 medication for weight loss has been approved for use in the U.S.
The Wegovy pill, from drugmaker Novo Nordisk, was cleared by the Food and Drug Administration to reduce excess body weight, maintain long-term weight reduction and lower the risk of major cardiovascular events.
Approval of the once-daily 25mg semaglutide pill was based on the results of two clinical trials — the OASIS trial program and the SELECT trial.
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The Wegovy pill demonstrated a mean weight loss of 16.6% in the OASIS 4 trial among adults who were obese or overweight and had one or more comorbidities (other medical conditions), according to a press release. In the same trial, one in three participants experienced 20% or greater weight loss.
The first oral GLP-1 medication for weight loss has been approved for use in the U.S. (iStock)
Novo Nordisk reported that the weight loss achieved with the pill is similar to that of injectable Wegovy and has a similar safety profile.
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“With today’s approval of the Wegovy pill, patients will have a convenient, once-daily pill that can help them lose as much weight as the original Wegovy injection,” said Mike Doustdar, president and CEO of Novo Nordisk, in the press release.
Novo Nordisk reported that the weight loss achieved with the pill is similar to that of injectable Wegovy and has a similar safety profile. (James Manning/PA Images via Getty Images)
“As the first oral GLP-1 treatment for people living with overweight or obesity, the Wegovy pill provides patients with a new, convenient treatment option that can help patients start or continue their weight-loss journey.”
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The oral GLP-1 is expected to launch in the U.S. in early January 2026. Novo Nordisk has also submitted oral semaglutide for obesity to the European Medicines Agency (EMA) and other regulatory authorities.
“Most side effects will be GI-related and should be similar to the injectable, such as nausea, vomiting and constipation,” an expert said. (iStock)
Dr. Sue Decotiis, a medical weight-loss doctor in New York City, confirmed in an interview with Fox News Digital that studies show oral Wegovy is comparable to the weekly injectable, just without the needles.
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Although the pill may result in better compliance and ease of use, Decotiis warned that some patients may not absorb the medication through the gastrointestinal tract as well as with the injectable version due to individual idiosyncrasies in the body.
“Most side effects will be GI-related and should be similar to the injectable, such as nausea, vomiting and constipation,” she said.
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“In my practice, I have found tirzepatide (Mounjaro and Zepbound) to yield more weight loss and fat loss than semaglutide by about 20%,” the doctor added. “This has been shown in studies, often [with] fewer side effects.”
More oral GLP-1s may be coming in 2026, according to Decotiis, including an Orforglipron application by Lilly and a new combination Novo Nordisk drug, which is pending approval later next year.
One expert warned that some patients may not absorb the medication through the gastrointestinal tract as well as with the injectable version. (iStock)
“There will be more new drugs available in the future that will be more effective for patients who are more insulin-resistant and have not responded as well to semaglutide and/or tirzepatide,” the doctor said. “This is great news, as novel drugs affecting more receptors mean better long-term results in more patients.”
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As these medications become cheaper and easier to access, Decotiis emphasized that keeping up with healthy lifestyle habits — including proper nutrition with sufficient protein and fiber, as well as increased hydration — is essential to ensuring lasting results.
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“If not, patients will regain weight and could lose muscle and not enough body fat,” she said.
Fox News Digital reached out to Novo Nordisk for comment.
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A study from Sweden’s Uppsala University discovered a link between microplastics and multiple sclerosis (MS).
The research, published in the journal Environmental International, discovered that exposure to two common environmental contaminants, PFAS and PCBs, could increase the risk of the autoimmune disease.
PFAS, or per- and polyfluoroalkyl substances, known as “forever chemicals,” are used in some common household products, such as non-stick cookware, textiles and cleaning products. They have also been found in drinking water throughout the U.S., according to the U.S. Environmental Protection Agency.
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PCBs, or polychlorinated biphenyls, are toxic industrial chemicals once widely used in electrical equipment before being banned decades ago, as stated by the National Institute of Environmental Health Sciences.
The new study findings were based on blood samples of 1,800 Swedish individuals, including about 900 who had recently been diagnosed with MS, according to a university press release.
PFAS, or per- and polyfluoroalkyl substances, known as “forever chemicals,” are used in some common household products, including non-stick cookware. (iStock)
The first phase of the trial studied 14 different PFAS contaminants and three substances that appear when PCBs are broken down in the body. These were then investigated for a link to the odds of diagnosis.
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“We saw that several individual substances, such as PFOS and two hydroxylated PCBs, were linked to increased odds for MS,” lead study author Kim Kultima said in a statement. “People with the highest concentrations of PFOS and PCBs had approximately twice the odds of being diagnosed with MS, compared to those with the lowest concentrations.”
The researchers then examined the combined effects of these substances and found that the mixture was also linked to increased risk.
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Fellow researcher Aina Vaivade noted that risk assessments should consider chemical mixtures, not just individual exposures, because people are typically exposed to multiple substances at the same time.
“We saw that several individual substances, such as PFOS and two hydroxylated PCBs, were linked to increased odds for MS,” the lead study author said. (iStock)
The final phase of the study investigated the relationship between inheritance, chemical exposure and the odds of MS diagnosis, revealing that those who carry a certain gene variant actually have a reduced MS risk.
However, individuals who carried the gene and had higher exposure to PFOS — a singular type of chemical in the PFAS family — had an “unexpected” increased risk of MS.
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“This indicates that there is a complex interaction between inheritance and environmental exposure linked to the odds of MS,” Kultima said.
“We therefore think it is important to understand how environmental contaminants interact with hereditary factors, as this can provide new knowledge about the genesis of MS and could also be relevant for other diseases.”
Multiple sclerosis is a disease that leads to the breakdown of the protective covering of the nerves, according to Mayo Clinic. (iStock)
Fox News senior medical analyst Dr. Marc Siegel commented on these findings in an interview with Fox News Digital.
“MS is a complex disease that is somewhat autoimmune and somewhat post-inflammatory,” said Siegel, who was not involved in the study. “Epstein-Barr virus infection greatly increases the risk of MS.”
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“There is every reason to believe that environmental triggers play a role, including microplastics, and this important study shows a correlation, but not causation — in other words, it doesn’t prove that the microplastics caused MS.”
The study had some limitations, the researchers acknowledged, including that the chemical exposure was measured only once, at the time of blood sampling. This means it may not accurately represent participants’ long-term or past exposure levels relevant to MS development.
“There is every reason to believe that environmental triggers play a role.”
Fox News Digital reached out to several industry groups and manufacturers requesting comment on the potential link between PFAS chemicals and multiple sclerosis.
Several have issued public statements, including the American Chemistry Council, which states on its website that “manufacturers and many users of today’s PFAS are implementing a variety of practices and technologies to help minimize environmental emissions.”
In April 2024, the EPA enacted a new federal rule that sets mandatory limits on certain PFAS chemicals in drinking water, aiming to reduce exposure. The agency also aims to fund testing and treatment efforts.
A woman working out outdoors takes a sip of water from a plastic bottle. (iStock)
Multiple sclerosis is a disease that leads to the breakdown of the protective coverings that surround nerve fibers, according to Mayo Clinic.
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The immune system’s attack on these nerve sheaths can cause numbness, weakness, trouble walking and moving, vision changes and other symptoms, and can lead to permanent damage.
There is currently no cure for MS, Mayo Clinic reports, but treatment is available to manage symptoms and modify the course of the disease.
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