The dual personality of hemoglobin A 1c : precision medicine biomarker and population mortality predictor for both adult and geriatric patients

The rapid rise in prevalence of diabetes and the upward shift of population age distributions are coincident demographic changes that explain why older adults have become the fastest growing diabetic population. In 2017 what do we know about diabetes in older adults? The initial clinical trials that elucidated the associations between glycemic control, hemoglobin A 1c (HbA 1c ) as well as onset and development of diabetic complications focused on adults but often excluded ≥65 year olds (1,2).