Aspects of setting blood glucose targets in older adult diabetic patients using insulin

Abstract

This study aimed to clarify aspects of setting blood glucose targets for older adult patients with diabetes using insulin. We conducted semi-structured interviews with 10 patients and analyzed data using the Modified Grounded Theory Approach （M-GTA）.

As a result, the structure was described using seven categories and four concepts, generated from 23 initial concepts. Based on the idea of ［a life of medical treatment in which one makes daily efforts based on own will］, ＜initially, a low HbA1c target value was set＞. Moreover, because the ＜medical treatment was carried out together with the attending physician based on a trusting relationship>, as patients aged, ［although confused, patients thought of substituting their HbA1c target value for a more relaxed, age-appropriate one］. However, this was antagonized by ［the optimal HbA1c target value that cannot be abandoned］, and this antagonism was influenced by ＜changes in HbA1c target values, which were not fully understood＞. Furthermore, ［the fear of hypoglycemia, which patients seemed to know but not understand］, influenced the optimal target values that they could not abandon.

The findings highlight the need for medical professionals to endeavor to understand how patients perceive their target blood glucose values. The results suggest they must collaboratively consider and support setting safe blood glucose targets in older adult patients with diabetes requiring insulin therapy.