Measure titleGlycemic ControlMeasure IDGCD_DRP
Description

The percentage of patients 18–75 years of age with diabetes whose most recent hemoglobin A1c (HbA1c) or glucose management indicator (GMI) was <8.0% during the measurement period.

Measurement period.
Copyright and disclaimer notice

This measure and specification was developed by and is owned by the National Committee for Quality Assurance (“NCQA”). Financial support was provided via a grant from the Leona M. & Harry B. Helmsley Charitable Trust. NCQA holds a copyright in these materials and may rescind or alter these materials at any time. Users of the measure and specification shall not have the right to alter, enhance or otherwise modify the measure and specification, and shall not disassemble, recompile or reverse engineer the measure and specification. Anyone desiring to use or reproduce the materials, without modification for an internal non-commercial purpose may do so without obtaining any approval from NCQA. All other uses, including a commercial use (including but not limited to vendors using the measure and specification with a product or service to calculate measure results), or any external reproduction, distribution and publication of the measure or results (“rates”) therefrom must be approved by NCQA and are subject to a license at the discretion of NCQA. Any use of the materials to identify records or calculate measure results, for example, requires a custom license and may necessitate certification pursuant to NCQA’s Measure Certification Program.

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Clinical recommendation statement

American Diabetes Association (2022)

  • Assess glycemic status (A1C or other glycemic measurement such as time in range or glucose management indicator) at least two times a year in patients who are meeting treatment goals (and who have stable glycemic control). Level of evidence: E
  • An A1C goal for many non-pregnant adults of <7% (53 mmol/mol) without significant hypoglycemia is appropriate. Level of evidence: A
  • On the basis of provider judgment and patient preference, achievement of lower A1C levels than the goal of 7% may be acceptable and even beneficial if it can be achieved safely without significant hypoglycemia or other adverse effects of treatment. Level of evidence: B
  • Less stringent A1C goals (such as <8% [64 mmol/mol]) may be appropriate for patients with limited life expectancy or where the harms of treatment are greater than the benefits. Level of evidence: B
  • Standardized, single-page glucose reports from continuous glucose monitoring (CGM) devices with visual cues, such as the ambulatory glucose profile, should be considered as a standard summary for all CGM device. Level of evidence: E

Joslin Diabetes Center (2020)

  • A goal of <7.0% (53 mmol/mol) is chosen as a practical level for most patients to reduce the risk of long-term complications of diabetes. Achieving this goal is recommended if it can be done safely and practically. Grade of Recommendation: 1B
  • Monitor the A1C 2-4 times a year as part of the scheduled medical visit. Grade of Recommendation: 1C
Citations

American Diabetes Association (ADA). 2022. “6. Glycemic Targets: Standards of Medical Care in Diabetes–2022.” Diabetes Care 2022; 45(Suppl. 1):S66–S76. https://doi.org/10.2337/dc22-S006

Joslin Diabetes Center. (2020). Joslin Diabetes Center’s Clinical Guidelines for Management of Adults with Diabetes. Joslin Diabetes Center’s. https://joslin-prod.s3.amazonaws.com/www.joslin.org/assets/2020-08/clinicalguidelinesformanagementofadultswithdiabetes.pdf

Characteristics
ScoringProportion.
TypeOutcome.
Stratification
None.
Risk adjustmentNone.
Improvement notationA higher rate indicates better performance.
Guidance

If there are multiple glycemic results on the same day, use the lowest value as the most recent glycemic result.

For Glucose Management Indicator (GMI), results from the Ambulatory Glucose Profile Report should be used to assess glycemic control.

Definitions
Initial population

Patients 18-75 years of age by the end of the measurement period who had a visit during the measurement period, and a diagnosis of diabetes that is ongoing or starts during the first six months of the measurement period.

Exclusions

  • Patients in hospice or using hospice services any time during the measurement period.
  • Patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period.
  • Patients 66 and older by the end of the measurement period, with frailty and advanced illness.
  • Patients receiving palliative care during the measurement period.

Denominator

The initial population, minus exclusions.

Numerator

Patients whose most recent glycemic result (HbA1c or GMI) performed during the measurement period is <8.0%. The patient is not numerator compliant if the result for the most recent glycemic test is ≥8.0% or is missing a result, or if a glycemic test was not done during the measurement period.

Data criteria (element level)

Table of Contents

  1. Definitions
  2. Functions

Definitions

Functions