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Diabetes guidelines and organizations typically advocate a target glycated hemoglobin (A1C) value of 6.5–7.0% but highlight that glycemic management must be individualized. Whereas individualization of both glycemic targets and management is appealing to the clinician as a way of potentially maximizing benefit while minimizing risk, there is little evidence that such an approach will bring more patients to target. It may be argued that this approach could contribute to fewer patients attaining optimal glycemic targets. Nonetheless, the results of recent large outcome trials clearly highlight the fact that individual glycemic target achievement varied markedly, with some patients apparently deriving more clinical benefit and others deriving more harm. At the same time, there is ongoing evidence of a treatment gap in many surveys of clinical practice and a suggestion that algorithm-driven protocols may be more effective. Collectively, therefore, the currently available evidence suggests that algorithm-driven protocols that incorporate individualized targets based on patient characteristics designed to preserve a sound balance between the benefits and risk of good glycemic control may be an appropriate way of getting more patients to target in a safe and effective manner.Over 280 million people worldwide are known to have diabetes (1), and this number is projected to grow to 438 million by 2030 (2). Current diabetes treatment guidelines (3–9) encourage a multifaceted therapeutic approach (10,11). Central to these recommendations is early diagnosis and active intervention to realize and maintain glycemic control, with the aim of stopping the development of microvascular complications, reducing the risk of macrovascular events, and ameliorating the symptoms of acute hyperglycemia (7,10–17).The prognostic significance of A1C in regard to the incidence of diabetes complications, and the risk reductions associated with improvements in A1C, have been documented in both type 1 (12, …

Should A1C Targets Be Individualized for All People With Diabetes?