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?”
Health
Hantavirus Vaccines and Treatments Are in the Pipeline
The deadly hantavirus outbreak aboard the cruise ship MV Hondius has put the spotlight on a rare pathogen that typically attracts relatively little attention, even from scientists.
There are no targeted treatments for hantaviruses, which are typically carried by rodents, and no widely available vaccines. So when passengers began falling ill in the middle of the Atlantic Ocean, doctors and public health experts were limited in what they could offer.
“It’s kind of a wake-up call,” said Dr. Vaithi Arumugaswami, an infectious disease researcher at the University of California, Los Angeles. “Our tool kit is almost empty.”
That’s not for lack of trying. A handful of scientific teams around the world have been working — for decades, in some cases — to develop hantavirus treatments and vaccines. But it has not been easy to find funding or nurture commercial interest in medical interventions for a type of pathogen that does not infect humans often and does not spread easily between people.
“It’s not an airborne, highly contagious viral threat, so it hasn’t been as high a priority for groups trying to prevent pandemics,” said Jay Hooper, a virologist at the United States Army Medical Research Institute of Infectious Diseases.
But there are promising vaccines and treatments in development. And some of them, experts said, could be moved through the pipeline rapidly if hantavirus interventions became a priority.
“I do think there are things that are sitting there on the bench that could be quickly developed,” said Dr. Ronald Nahass, the president of the Infectious Diseases Society of America. “But nothing is ready.”
Vaccine development
There are two main types of hantaviruses: Old World viruses, which circulate primarily in Asia and Europe, and New World viruses, which are found in the Americas. The cruise ship outbreak has been linked to a New World virus known as the Andes virus, which is endemic to South America and is the only hantavirus known to spread between people.
There are vaccines that target some of the Old World viruses in Asia, but their efficacy is modest, experts said. And there are no licensed vaccines for the New World viruses, which include the Sin Nombre virus endemic to rodents in the western United States.
But there are some in development. Dr. Hooper and his colleagues have developed a DNA vaccine for the Andes virus, which proved promising in a small phase 1 trial. Under certain dosing regimens, the researchers found, more than 80 percent of participants produced neutralizing antibodies. “It’s pretty amazing,” said Dr. Hooper, who is an inventor on multiple hantavirus vaccine patents owned by the U.S. government. “Getting these kinds of neutralizing antibodies in humans is impressive.”
There were drawbacks, including that the vaccine seemed to require at least three doses. But the vaccine is ready for further development “if there’s a need,” Dr. Hooper said. “We’ve done the science. It’s just other forces that are required to move vaccines forward — markets, government demand.”
Other teams have potential vaccines in earlier stages of development. For instance, Bryce Warner, a hantavirus researcher at the University of Saskatchewan, and his colleagues are exploring a variety of approaches, including a nasal vaccine that they hope might spark a more robust immune response in the airway.
But the research, which is being conducted in hamsters, is still in early stages, and hantavirus vaccine candidates can be challenging to move forward. Scientists lack good large-animal models for hantaviruses, Dr. Warner said, and human cases are rare enough to make trials tricky. “It’s very difficult to conduct a clinical trial when you only have a limited number of cases annually,” he said. “You don’t have the numbers of people to really show a robust effect.”
Drug hunting
Currently, the primary treatment for hantavirus infection is supportive care, which may include supplemental oxygen or heart-lung bypass machines. Doctors also sometimes prescribe an existing antiviral drug, called ribavirin, but there is not strong evidence that it is effective for New World viruses, scientists said.
The hunt for new drugs is underway, though. At U.C.L.A., Dr. Arumugaswami and his colleagues found that favipiravir, an antiviral approved to treat influenza in Japan, inhibited the Andes virus in human cells. They also identified several compounds that had broad antiviral activity, blocking hantaviruses as well as other types of viruses, in human organoids, miniature clusters of tissue that mimic the function of organs.
Other teams have been working to develop therapeutic antibody treatments, often working from blood samples collected from hantavirus survivors. “We were able to isolate the natural antibodies that people are making and basically winnow them down and find one that was really good,” said Kartik Chandran, a virologist at the Albert Einstein College of Medicine in New York. “We actually found several.”
When Dr. Chandran and his colleagues tested these antibodies in hamsters, one produced especially encouraging results: It seemed to work against both Old and New World hantaviruses and was effective even when given relatively late in the course of infection, Dr. Chandran said.
(Dr. Chandran is listed as an inventor on patents for hantavirus antibodies.)
Several other teams have also produced antibodies that were broadly effective in small animals, but that is where a number of potential products have stalled, experts said.
“We have a lead drug, and now what we need is someone to pay the money, which would be something like $40 million, to go the next step,” said Dr. James Crowe, director of the Vanderbilt Center for Antibody Therapeutics. “We have neither government nor foundation nor company support to do that. So we’re just waiting to find a partner.”
(Vanderbilt University has applied for patents related to these antibodies; Dr. Crowe is listed as the inventor.)
Experts said that they hoped the current outbreak might help bring attention to a family of often-overlooked viruses.
“Certainly judging by just my inbox and text messages, there’s a renewed interest in these agents, and renewed interest in maybe at least revisiting where they are in the priority list,” Dr. Chandran said.
Whether that interest can be sustained after the virus fades from the headlines remains to be seen, experts acknowledged.
“Raising awareness never hurts,” Dr. Warner said. “We’ll see whether or not it leads to anything tangible, at least in terms of funding and resources for advancing some of these things that are lacking for hantavirus.”
Health
Fitness expert visits gyms nationwide, shouts out 4 clubs for ‘getting it right’
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Gym membership in the U.S. hit a record high in 2025, according to the Health & Fitness Association, giving consumers more workout options — and more choices to sort through when picking the right fitness space.
Amid today’s wellness renaissance, many gyms and fitness clubs can cost hundreds of dollars per month, depending on the level of access and amenities offered.
In an interview with Fox News Digital, Kenny Santucci — New York City fitness trainer, gym owner and host of the “Strong New York” podcast — revealed the attributes of a great gym.
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“A lot of people traditionally look at gyms [as if] they have to have all the bells and whistles,” he said. “Spa, bathrooms, all these things. For me, a gym is a gym. I go there for the equipment, I go for the culture, I go for the look and feel of the place.”
He added, “You can have an incredible gym [that’s] a garage gym, and you can have an incredible gym [that] somebody could have built for $10 million.”
Amid today’s wellness renaissance, many gyms and fitness clubs can cost hundreds of dollars per month, depending on the level of access and amenities offered. A New York City fitness trainer (not pictured) has a different view of what makes the best gyms.
Santucci, who visits new gyms across the country and posts his experiences on social media, said he looks for a balance between aesthetics and equipment quality, as well as “great people.”
“I think you could go and get in a sweat or a workout anywhere — but if the people are great, that’s what creates that great culture,” he said.
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“If you ask the average person who goes to most big-box gyms, the things they tell you they love about the gym are, ‘Oh, I love the showers. They have really nice towels.’ It’s nothing that actually pertains to the gym, and I believe that people should go to the gym to progress and get better,” he added.
With these goals in mind, Santucci revealed some of his top-rated gyms in the U.S.
Life Time Fitness
Life Time is a chain of luxury health clubs in the U.S., offering amenities like indoor courts, swimming pools, saunas and group fitness classes.
Santucci applauded the gym’s founder and CEO, Bahram Akradi, for being a “very hands-on owner and operator,” overseeing hundreds of gyms across the country.
The facade of an upscale Lifetime gym is shown in Walnut Creek, California, on April 8, 2025. (Smith Collection/Gado/Getty Images)
“[Bahran’s] mentality and belief system around the fitness space, I absolutely love,” he said.
“I give a lot of credit to the guys who are owners and operators,” Santucci added. “They’re in the space, they’re making sure things are going really well. I think if you’re going to be in the gym business, you should be one of those people.”
Anatomy Gyms (Florida)
Santucci also shouted out Marc Megna, co-founder and co-CEO of Florida-based Anatomy Fitness for building a must-visit space.
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“It’s an incredible culture there, and I think that’s what they really push at that gym,” he said.
“The way the gym’s set up, the cleanliness of it, the aesthetics – you walk in that place, and you want to train … and those are things you can’t just buy … You have to live it, love it and be involved in the day-to-day operations.”
Powerhouse (New York/New Jersey)
In a newer recommendation, Santucci said he’s enjoyed stopping into Powerhouse Gym in New York City.
The New York- and New Jersey-based gym focuses on weight training and bodybuilding, including a powerlifting room and boxing rig at its locations.
“I just started going there, once or twice a week,” he said. “I really love the people and the culture.”
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The Training Lab (NYC)
For more of a group fitness and Hyrox training experience, Santucci recommends The Training Lab in New York City. (Hyrox is a global fitness racing brand and training system with affiliated gyms and training clubs.)
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“The guys over at Training Lab are incredible,” he told Fox News Digital. “Another owner-operator who’s involved in the business, who partakes in everything. I think they’re another great gym.”
“If you’re looking for group training, Training Lab’s a great space.”
Participants compete in the burpee broad jumps event during the Hyrox fitness race at the Bangkok International Trade and Exhibition Centre in Bangkok on March 21, 2026. (Amaury Paul/AFP)
The price of wellness
While some premier gym memberships can cost upward of $300 a month, Santucci said it isn’t necessary to spend a lot to get results, although it may result in more of an “experience.”
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“We need to restructure the way we think about health and wellness,” he said. “People aren’t going out as much anymore. They’re not spending as much on alcohol.
“It’s all what you prioritize. I prioritize fitness,” he went on. “I belong to multiple gyms. I have a membership to TMPL Gym here in [New York City]. I have a membership to Renzo Gracie’s. That’s what I like to do with my money.”
While some premier gym memberships can cost upward of $300 a month, Santucci emphasized that it isn’t necessary to spend a lot to get results. (iStock)
Santucci said what he’s paying for goes beyond the equipment — pointing to the staff, community and overall atmosphere as part of the value.
“If you want that elevated experience, you’re going to pay for that just like you would at a hotel or a restaurant or anything else,” he said.
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The expert suggested that wellness has recently become a “third form of hygiene.”
“It’s like you take a shower, you brush your teeth and you go to the gym,” he said. “I think those are three non-negotiables for almost everybody on a daily basis when it comes to your hygiene.”
Health
There Are Ants in This Canadian Hospital. Again.
Ants can be a nuisance. Just ask officials at a hospital in Canada who are dealing with an “appearance of ants within the operating room” that has forced them to indefinitely suspend some surgeries there.
The ants appeared recently at Carman Memorial Hospital in Carman Manitoba, according to a statement from Southern Health-Santé Sud, the provincial authority that oversees the hospital.
It was not clear when the hospital would resume operations, but Southern Health said on Friday that a “limited number of elective surgeries” had been postponed and that the hospital was working with patients to reschedule them. Portage Online, a local news website, reported that 16 operations had been postponed, citing information from Southern Health.
It’s not the first time ants have disrupted operations at the hospital. The insects appeared there in August 2024, but “the issue resolved within a few weeks,” Southern Health said. They returned last summer. But with their reappearance this week, the hospital said it was taking more drastic measures. The hospital serves the area around Carman, a town with a population of around 3,000 residents about 47 miles southwest of Winnipeg.
“Any factor that could impact the safety or integrity of the operating room environment requires the suspension of surgical activity until the issue can be resolved,” Southern Health said. “The safety of patients, staff and physicians is paramount.”
The hospital is working with exterminators “to identify the source of the ants and implement additional measures and support a long-term resolution.” Southern Health told Portage Online that exterminators had “surveyed and cleaned drains, opened walls and sealed cracks.”
“Several methods have been used to bait the ants in an effort to find where they are originating from,” the authority said.
In a separate statement to the CBC, Southern Health said that it believed that an ant colony had made its home near the hospital and that they appeared to be “simply seeking food sources inside buildings as ants are known to do.”
The hospital also told the CBC that the ant problem at the hospital did not amount to an “infestation.”
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