Treatment

Doctors Recognize Need for Individualized A1C Goals

When calculating a person’s ability to control their diabetes, doctor’s measure their HbA1c (or A1C for short) score, which defines average blood sugar levels over a long period of time. The idea until recently has been that there is a standard range of A1C scores that every person with diabetes should shoot for, but many with the condition fall short of those numbers. Now, a new study challenges that conventional wisdom.

Israeli researchers have created an algorithm that works holistically to create individualized target A1C scores for individuals with Type 2 diabetes, according to a Medscape Medical News article. The equation, the result of a survey of some 150 worldwide opinion leaders in diabetology, includes objective factors like risk of hypoglycemia and presence of comorbidities. The equation also accounts for more subjective factors, like what kind of support system an individual with diabetes might have outside of the doctor’s office or the individual’s motivation to improve his or her health.

The algorithm is a response to a joint position statement passed in 2012 by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) that called for a more patient-centered approach. It’s believed that providing individually tailored standards help both patient and practitioner to create a working relationship that focuses on the goal of an individual’s improved health.

In the article, Dr. Anne Peters, a professor of clinical medicine at the University of Southern California, Los Angeles, says this new way of thinking calls into question the fundamental idea of “normalized” blood sugar levels; Dr. Peters was not involved in the study. She believes that the algorithm used to create individualized A1C scores, while not perfect, can facilitate open conversations between patients and their doctors about realistic health goals.

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