• Printer-friendly Adult Clinical Measure 10: Diabetes Detail Sheet (Acrobat/pdf)

# of adults with type 1or type 2 diabetes who:

• were ages 18-75 years old during the calendar year of interest
• were served in the calendar year of interest
• have at least one HbA 1c reading documented in the calendar year of interest and whose last recorded value in the calendar year of interest is <7%
  

# of adults with type 1 or type 2 diabetes who

• were ages 18-75 years old during the calendar year of interest
• were served in the calendar year of interest; had one encounter for any reason whatsoever.
• Include in denominator even if did not have HbA1c done
  

A Diabetes Report Card for the United States: Quality of Care in the 1990s. Annals 2002 136: 565-574 :
42.9%

See: http://www.annals.org/cgi/content/full/136/8/565

If Chart Audit, then sample from the sample frame of persons meeting denominator criteria.

Note: This measure has frequently been selected, due to the ready accessibility of data, when the grantee participates in the Chronic Disease Collaborative for diabetes. Enrolled patients frequently represent a small subset of diabetics seen at a CHC, and if there are multiple sites, may represent performance at only one site. This raises questions about how representative is the data in PECS, or whatever database is used to track these patients.

An estimated 7% of the U.S. population has diabetes. Diabetes is widely recognized as one of the leading causes of death and disability in the U.S. In 2002, it was estimated that diabetes cost the U.S. $132 billion in such areas as disability payments, time lost from work, premature death, hospitalizations, medical care, etc.
Diabetes is associated with long-term complications affecting almost every part of the body. If uncontrolled, diabetes can lead to blindness, heart and blood vessel disease, stroke, kidney failure, amputations, and nerve damage. In addition, complications of pregnancy and birth defects are common in babies of diabetic mothers.
For more information, see:
http://diabetes.niddk.nih.gov/dm/pubs/overview/index.htm

Minority populations are disproportionately affected by diabetes. From 1980 through 2004, the age-adjusted prevalence of diagnosed diabetes increased among all sex-race groups examined. From 1980 through 2004, the age-adjusted prevalence of diagnosed diabetes was higher among blacks than whites and highest among black females. During this time period, age-adjusted prevalence increased 76% among white males, 65% among white females, 68% among black males and 37% among black females. Among Hispanics, the age-adjusted prevalence among males and females were higher in 2004 than in 1997.”CDC. National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2005. Atlanta, GA: US Department of Health and Human Services, CDC; 2005. See: http://www.cdc.gov/diabetes/pubs/factsheet05.htm
For additional information on this and related measures, see:
http://www.healthdisparities.net/hdc/html/collaboratives.topics.diabetes.aspx

The measurement and monitoring of levels of HgA1C is the barometer for diabetes control.
“Lowering A1C has been associated with a reduction of micro vascular and neuropathic complications of diabetes…with an A1C goal of <7%.”
Standards of medical care in diabetes. Diabetes Care. 2004 Jan; 27 Suppl 1:S15-35.
See: http://care.diabetesjournals.org/cgi/reprint/27/suppl_1/s15

For the clinical practice guidelines that go with this measure, see:
http://www.diabetes.org/for-health-professionals-and-scientists/cpr.jsp