Diabetes

Adequate control of HbA1c in individuals with diabetes mellitus (ages 18-84 years)

Individuals achieving glycemic control (numerator), among Individuals aged 18-84 years with diabetes who had at least one documentation of HbA1c-level (denominator)

Rational:

Diabetes is a complex group of diseases marked by high blood glucose (blood sugar), occurring due to the body’s inability to make or use insulin. Left unmanaged, diabetes can lead to serious complications, including heart disease, stroke, hypertension, blindness, kidney disease, diseases of the nervous system, amputations and premature death [1]. During 2012-2014 5.6% of mortality cases in Israel were attributable to diabetes, becoming the fourth most common cause of death [2]. Proper diabetes management is essential to control blood glucose, reduce risks for complications and prolong life [1]. The continuous efforts to balance between the prevention of long-term micro-and macro-vascular complications associated with uncontrolled diabetes, and the prevention of hypoglycemic events had let to customized target levels for HbA1c [3], also adopted in Israel [4].

Numerator:

Individuals in the denominator achieving glycemic control, according to their last hemoglobin A1c level in the measurement year: <=7% among 18-74 years-old patients who were diabetics for less than 10 years; <=8% among 18-74 years-old patients who were diabetics for at least 10 years;<=8% among 75-84 years-old patients

Denominator

Individuals aged 18-84 years with diabetes who had at least one documentation of HbA1c-level in the measurement year

Notes:

None

Notes:

[1] American Diabetes Association (ADA), “Standard of medical care in diabetes - 2017,” Diabetes Care, 40(sup 1):s4–s128, 2017.
[2] In Hebrew: Leading causes of death in Israel 2000-2014, Ministry of Health, March 2017. Available: https://www.health.gov.il/publicationsfiles/leading_causes_2014.pdf
[3] Fang, Hong-Juan et al. Effects of intensive glucose lowering in treatment of type 2 diabetes mellitus on cardiovascular outcomes: A meta-analysis of data from 58,160 patients in 13 randomized controlled trials. International Journal of Cardiology, Volume 218 , 50 – 58.
[4] In Hebrew: Position (1-lowest, 4-highest) paper- יעדי מטרה לאיזון סוכרת 2016, ההסתדרות הרפואית בישראל, המכון לאיכות ברפואה. Available at: https://www.ima.org.il/userfiles/image/Ne60_diabetes.pdf

Results:
Adequate control of HbA1c by year
Adequate control of HbA1c by socio-economic position (1-lowest, 4-highest) and sex


National Program for Quality Indicators in Community Healthcare
התכנית הלאומית למדדי איכות לרפואת הקהילה בישראל