Diabetes

Uncontrolled diabetes: HbA1c greater than 9% in children with diabetes mellitus (ages 2-17 years)

Individuals with uncontrolled diabetes (defined as HbA1c levels> 9%) (numerator), among Individuals aged 2-17 years with diabetes (denominator)

Rational:

Diabetes in youth presents a substantial clinical and public health burden. The incidence of type 1 diabetes in youth (aged 0-17 years) in Israel have steadily increased, from 8.0 newly diagnosed cases per 100,000 in 1997 to 13.1 per 100,000 in 2012, with a total increase of 64%, or 0.33% annually [1]. Increases in incidence such as these, and even more pronounced, were observed in other developed countries, including the US with an annual increase of 1.5% between 2002 and 2012 [2]. Due to the complexity of the management of diabetes in children the ADA recommends that multidisciplinary professionals, within specialized diabetes clinics, follow-up and care for children with diabetes [3]. This is the standard practice in Israel. Also, a seasonal influenza vaccine is recommended in Israel for the whole population, with a special emphasis on children and on persons of all ages with chronic diseases [4].

Numerator:

Individuals in the denominator with uncontrolled diabetes (defined as HbA1c levels > 9%)

Denominator

Individuals aged 2-17 years with diabetes and a documentation of HbA1c levels in the measurement year

Notes:

None

Notes:

[1] Blumenfeld O, Dichtiar R, Shohat T; The Israel IDDM Registry Study Group (IIRSG). Trends in the incidence of type 1 diabetes among Jews and Arabs in Israel. Pediatr Diabetes. 2013 Nov 27. doi: 10.1111/pedi.12101.
[2] Mayer-Davis EJ et al., Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002–2012. N Engl J Med 2017; 376:1419-1429. DOI: 10.1056/NEJMoa1610187
[3] American Diabetes Association (ADA), “Standard of medical care in diabetes - 2017,” Diabetes Care, vol. 40 (sup 1), no. January, pp. s4–s128, 2017.
[4] In Hebrew: 2017 ,“1999האגף לאפידמיולוגיה משרד הבריאות, “תדריך חיסונים . [Online]. Available: https://www.health.gov.il/UnitsOffice/HD/PH/epidemiology/td/docs/tadrich_Chisunim.pdf [Accessed: 12-June-2018]

Results:
Uncontrolled diabetes in children by year
Uncontrolled diabetes in children 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