Two new studies published in JAMA Internal Medicine suggest doctors should focus on working with some at-risk patients to cut back on medications that treat diabetes and blood pressure.

Researchers from the University of Michigan Medical School and the VA Ann Arbor Healthcare System reviewed patient records and conducted a survey of primary care providers to see if they had followed guidelines calling on physicians to treat some cases less aggressively.

They focused on people over 70 with diabetes whose blood sugar and pressure were well controlled by medicine. Low readings among those patients can increase the risk of dizzy spells, confusion, falls and death.

The team found one in four patients who could have safely had their dosages changed had been given new prescriptions. Even those with the fewest projected years left to live had only a slightly greater chance of having treatment dialed back.

Only about half of the healthcare providers surveyed said they would cut back treatment of a hypothetical patient with ultra-low sugar levels. They cited fears about patient harm, clinical report cards and liability.