7 de septiembre de 2021
To support quality care, we are providing information to providers and members to encourage discussions on health topics. Watch for more on health care quality in News and Updates.
More than 34 million Americans – just over one in 10 – have diabetes, according to the Centros para el Control y la Prevención de Enfermedades (CDC) 
. Because symptoms can develop slowly, one in five don't know they have it. We encourage providers to talk with our members about diabetes, including:
- Tipo 1 y Tipo 2 symptoms
- Regular eye exams to avoid vision loss, or diabetic retinopathy
- Screenings for kidney disease, or diabetic nephropathy
Why Diabetes Care Is Important
If left unmanaged, diabetes can lead to serious complications. These may include heart disease, stroke, hypertension, blindness, kidney disease, diseases of the nervous system, amputations and premature death. Providers play an important role in supporting our members through regular screenings, tests and office visits. Vea nuestras cuidado preventivo y clinical practice guidelines on diabetes, and tools from the CDC .
Closing Care Gaps
As part of monitoring and helping improve quality of care, we track Comprehensive Diabetes Care (CDC) . CDC is a Healthcare Effectiveness Data and Information Set (HEDIS®) measure from the National Committee for Quality Assurance (NCQA). It applies to our members ages 18 to 75 with diabetes (type 1 or type 2) who had the following during the measurement year:
- Hemoglobin A1c (HbA1c) testing
- HbA1c poor control (>9.0%)
- HbA1c control (<8.0%)
- Examen de retina
- Medical attention for nephropathy
- Blood pressure control (<140/90 mm Hg)
In addition to CDC, we track Kidney Health Evaluation for Patients with Diabetes (KED) . This is a HEDIS measure developed by NCQA with input from the National Kidney Foundation. It applies to our members ages 18 to 85 with diabetes (type 1 or type 2) who received a kidney health evaluation. An evaluation is defined by an estimated glomerular filtration rate (eGFR) and a urine albumin-creatinine ratio (uACR) during the measurement year.
Tips to Consider
- Identify care gaps and schedule lab tests before office visits to review results and adjust treatment plans if needed.
- Complete urine protein testing for attention to nephropathy at any office visit. Testing includes basic urinalysis by dip stick or tablet reagent.
- Document medication adherence to angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARB) when applicable.
- Repeat abnormal lab tests later in the year to document improvement.
- Monitor blood pressure status at each visit and adjust medications as needed for control.
- Encourage members with diabetes to have annual retinal eye exams by an eye care specialist.
- Communicate with members and other treating providers to ensure all tests are completed and results are documented in the medical record.
El material que se muestra anteriormente tiene fines informativos únicamente y no reemplaza el juicio médico independiente de un médico u otro profesional médico. Se recomienda a los médicos y otros profesionales médicos que usen su propio criterio médico basado en toda la información disponible y en la condición del paciente para determinar el curso de tratamiento apropiado. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their coverage documents for more details, including benefits, limitations and exclusions. Independientemente de los beneficios, la decisión final sobre cualquier servicio o tratamiento la toman el asegurado y su médico.
HEDIS es una marca comercial registrada de NCQA. Use of this resource is subject to NCQA's copyright, found here.
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