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The hemoglobin A1c (HbA1c) test measures your average blood sugar levels from the past two to three months. Most people with diabetes are told they should keep their HbA1c level below seven. But a research analysis says this one-size-fits-all approach may have shortcomings.
The findings indicate that tailoring blood sugar target numbers to the individual may improve quality of life while costing less.
Calculating the costs
Researchers at the University of Chicago Medicine estimated the projected lifetime health costs of more than 500 adults in the United States over age 30 who have type 2 diabetes. They included both typical costs of treating diabetes and expenses of possible complications such as a heart attack.
Running 2,500 computer simulations, the researchers compared what would likely happen in each person’s expected lifetime if they got standard treatment to keep their HbA1c below seven or if they instead were given a personalized HbA1c goal which changed over their lifetime. Which treatment would lead to better outcomes?
In determining the best individualized HbA1c goals, some people’s target number was higher than seven while others’ goal was lower. It depended on risk factors such as age, complications, other health problems, and how long the person has lived with diabetes.
Understanding the findings
Research results showed that a lifetime of individualized treatment would cost $13,564 less per person compared to standard treatment. The savings come mostly from needing much less medication. People on individualized care were also projected to have fewer episodes of dangerously low blood sugar (hypoglycemia).
Because of those benefits, individualized-care participants were expected to have a higher quality of life for a slightly longer part of their lifetime than people who received standard care.
There was a small downside, though. Projected life expectancy was about one month less for those with individualized goals, and they were likely to have slightly more complications. That might sound troubling, but researchers say it may be nothing more than a blip in the numbers caused by statistical limitations in the model they used.
"I think this model will give evidence to physicians that individualized glycemic control is something to consider,” said Neda Laiteerapong, MD, assistant professor of medicine at University of Chicago Medicine and lead author of the study, in a news release. “It can help save our health system money, and it's in line with what many patients want."
Taking less medicine and not having to obsess about a hard-to-reach HbA1c goal might sound appealing, but never change your diabetes regimen on your own. Consider asking your doctor whether your current HbA1c target is ideal.
Do you rely more on periodic HbA1c results or daily blood sugar tests to help you manage diabetes? Tell us how you get the most from your test information by adding a comment below.