Hemoglobin is a protein inside red blood cells that helps carry oxygen from the lungs to the rest of the body. Glucose (sugar) in the blood slowly attaches to hemoglobin to form hemoglobin A_1c (HbA_1c). The more glucose in the blood, the more HbA_1c is formed. As a result, the percentage of hemoglobin that is HbA_1c reflects the average value for blood sugar during the previous 2 to 3 months. The American Diabetes Association encourages people to use the percentage of HbA_1c to keep track of how well their diabetes is being controlled, and until recently doctors would tell people to aim for a target of 7%. But, when everyone has the same target, some people have blood sugar values that are too high and others have values that are too low. As a result, many doctors now increase or decrease the target according to the person's age, medical history, and remaining years of life and how likely they are to have very low blood sugar, which is especially dangerous.

No one knows how much it costs to use different HbA_1c targets for different people instead of using the same target for everyone.

People with type 2 diabetes who represented all such people in the United States.

The researchers created a computer model that combined existing information about the frequency of problems with existing information about how much it costs to treat those problems. The researchers then used the model to predict what problems people might have in the future, how long they would live, and how much it would cost to provide their care.

Using different targets for different people led to fewer medications, less expensive care, and a slightly shorter length of life but a slightly higher quality of life.

Younger people who don't mind taking a lot of medications might be better off with an HbA_1c target of 7%.

If individualized HbA_1c targets are used more often, people will take fewer medications and will have less expensive care and better quality of life.

血红蛋白是红细胞中的一种蛋白质，有助于将氧气从肺部运送到身体的其他部位。血液中的葡萄糖（糖）缓慢附着在血红蛋白上，形成血红蛋白A _1c（HbA _1c）。血液中的葡萄糖越多，形成的HbA _1c就越多。结果，HbA _1c的血红蛋白百分比反映了前2到3个月的血糖平均值。美国糖尿病协会鼓励人们使用HbA _1c的百分比跟踪糖尿病的控制状况，直到最近，医生还告诉人们将目标设定为7％。但是，当每个人都有相同的目标时，有些人的血糖值过高，而另一些人的血糖值过低。结果，许多医生现在根据人的年龄，病史和剩余寿命以及他们可能会产生非常低的血糖的可能性来增加或减少目标，这特别危险。

没有人知道为不同的人使用不同的HbA _1c目标而不是为所有人使用相同的目标要花多少钱。

代表美国所有此类人群的2型糖尿病患者。

研究人员创建了一个计算机模型，该模型将有关问题发生频率的现有信息与有关解决这些问题的成本的现有信息结合在一起。然后，研究人员使用该模型预测人们将来可能遇到的问题，他们的生存时间以及提供护理的费用。

对不同的人使用不同的目标可以减少用药，减少护理费用，缩短寿命，但可以提高生活质量。

HbA _1c目标为7％，不介意服用大量药物的年轻人可能会更好。

如果更多地使用个性化的HbA _1c靶标，人们将减少用药，并且将减少昂贵的护理和更好的生活质量。