In geriatric diabetes care, primary care clinicians often chose to intensify glycemic control despite individual factors that may warrant higher glycemic targets based on existing ADA guidelines. Using a vignette-based survey, 336 primary care clinicians were queried on their intended management of geriatric patients with diabetes and whether they would intensity glycemic control by adding a second-line hypoglycemia medication. Researchers found:

• Despite recommendations for HbA_1c targets <8% for more complex patients, a woman aged 80 with an HbA_1c of 7.5%, longstanding diabetes, coronary disease, and cognitive impairment and with instrumental activity of daily living dependencies, had a predicted probability of treatment intensification of 35%.
• Internists were 11% and nurse practitioners were 15% more likely to intensify treatment than family physicians.
• Providers in Florida were more likely to intensify treatment.