A nurse is educating an otherwise healthy older adult with diabetes mellitus about diabetes treatment goals. Which of the following does the nurse recommend? (Select all that apply.)
Explanation & Rationale
A. Blood pressure <140/90: Maintaining blood pressure below 140/90 mmHg helps reduce the risk of cardiovascular and renal complications, which are common in older adults with diabetes. This target provides cardiovascular protection without imposing excessive treatment burden or risk of hypotension. B. Fasting or preprandial glucose 100–180 mg/dL: The recommended fasting or preprandial glucose range for healthy older adults with diabetes is typically 90–130 mg/dL. A target of 100–180 mg/dL is too broad and allows for higher glucose levels that increase the risk of long-term vascular complications. C. TSH level 5–10 units/mL: TSH levels are unrelated to diabetes management and reflect thyroid rather than glycemic control. Including TSH as a diabetes treatment goal is inappropriate since it pertains to endocrine function unrelated to glucose regulation. D. Bedtime glucose 90–150 mg/dL: A bedtime glucose range of 90–150 mg/dL helps prevent nocturnal hypoglycemia while maintaining adequate glycemic control. This range is appropriate for older adults, balancing safety with effectiveness in managing diabetes. E. Hemoglobin A1c value of <7.5: An HbA1c goal of less than 7.5% is appropriate for healthy older adults, reflecting good long-term glucose control without increasing hypoglycemia risk.