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  • Measure Summary
  • NQMC:009706
  • Jul 2014

Diagnosis and management of type 2 diabetes mellitus (T2DM) in adults: percentage of patients ages 18 to 75 years old with T2DM who are optimally managed, according to the specified components.

Redmon B, Caccamo D, Flavin P, Michels R, O'Connor P, Roberts J, Smith S, Sperl-Hillen J. Diagnosis and management of type 2 diabetes mellitus in adults. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2014 Jul. 85 p. [197 references]

View the original measure documentation External Web Site Policy

This is the current release of the measure.

This measure updates a previous version: Riethof M, Flavin PL, Lindvall B, Michels R, O'Connor P, Redmon P, Retzer K, Roberts J, Smith S, Sperl-Hillen J, Institute for Clinical Systems Improvement (ICSI). Diagnosis and management of type 2 diabetes mellitus in adults. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2012 Apr. 141 p.

The measure developer reaffirmed the currency of this measure in January 2016.

Measure Hierarchy

Diagnosis and Management of Type 2 Diabetes Mellitus in Adults

Age Group

UMLS Concepts (what is this?)

Primary Measure Domain

Clinical Quality Measures: Outcome

Secondary Measure Domain

Clinical Quality Measure: Process

Description

This measure is used to assess the percentage of patients ages 18 to 75 years old with type 2 diabetes mellitus (T2DM) who achieve any or all of the following control criteria:

  1. Glycated hemoglobin (HgbA1c) less than 8%
  2. Most recent blood pressure measurement less than 140/90 mmHg
  3. Tobacco free
  4. Established atherosclerotic cardiovascular disease (ASCVD) with documented daily aspirin use (unless contraindicated)
  5. Ages 40 to 75 years with T2DM and untreated low-density lipoprotein (LDL) greater than 70 mg/dL who are prescribed statin therapy
  6. All of the above

This measure represents the composite rate. This measure should be calculated as both an individual component met and a composite (all components met at the same time) measure. See the "Basis for Disaggregation" field for details.

Rationale

The priority aim addressed by this measure is to increase the percentage of patients ages 18 to 75 years with type 2 diabetes mellitus (T2DM) who are optimally managed.

Due to the high percentage of the United States (U.S.) population that is diagnosed with diabetes and the effect diabetes has on other comorbidities, appropriate management will improve the patient's experience of care and the health of the population, reducing office visits, emergency department visits, and cardiovascular complications. Other related conditions will in turn reduce the total cost of care.

Appropriate medication management targeting glycemic control, hypertension, and lipid management is important for reducing morbidity and mortality, and improving long-term quality of life for patients diagnosed with T2DM. Lifestyle changes such as nutrition therapy, weight loss, increased exercise, and appropriate education and self-management strategies are pivotal to improved outcomes. Inadequate access to care for chronic disease management as well as the cost of medication can contribute to poor control of T2DM and associated cardiovascular risk factors.

For most chronic diseases, including diabetes, the most efficient improvement strategy is to focus on a limited number of specific improvement goals. These may be based on observed gaps in care, potential clinical impact, cost considerations or other criteria (O'Connor, 2005). In T2DM, focusing on glycemic control, lipid control and blood pressure control is a strategy that has been shown to be effective in preventing up to 53% of heart attacks and strokes, the leading drivers of excess mortality and costs in adults with diabetes (Gaede et al., 2003).

Evidence for Rationale

Gaede P, Vedel P, Larsen N, Jensen GV, Parving HH, Pedersen O. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med. 2003 Jan 30;348(5):383-93. PubMed External Web Site Policy

O'Connor PJ. Commentary--improving diabetes care by combating clinical inertia. Health Serv Res. 2005 Dec;40(6 Pt 1):1854-61. PubMed External Web Site Policy

Redmon B, Caccamo D, Flavin P, Michels R, O'Connor P, Roberts J, Smith S, Sperl-Hillen J. Diagnosis and management of type 2 diabetes mellitus in adults. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2014 Jul. 85 p. [197 references]

Primary Health Components

Type 2 diabetes mellitus (T2DM); atherosclerotic cardiovascular disease (ASCVD); glycated hemoglobin (HgbA1c); blood pressure; low-density lipoprotein (LDL); statin therapy; tobacco use; aspirin use

Denominator Description

Number of patients ages 18 to 75 years old with type 2 diabetes mellitus (T2DM) (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

Number of patients who achieve all of the following control criteria:

  1. Glycated hemoglobin (A1c) less than 8%
  2. Most recent blood pressure measurement less than 140/90 mmHg
  3. Tobacco free
  4. Established atherosclerotic cardiovascular disease (ASCVD) with documented daily aspirin use (unless contraindicated)
  5. Ages 40 to 75 years with type 2 diabetes mellitus (T2DM) with untreated low-density lipoprotein (LDL) greater than 70 mg/dL who are prescribed statin therapy

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A clinical practice guideline or other peer-reviewed synthesis of the clinical research evidence

Additional Information Supporting Need for the Measure

  • Diabetes is a chronic disease that afflicts approximately 26.9% of United States (U.S.) residents aged 65 years and older. 1.9 million are diagnosed with diabetes every year, and an additional 7.0 million go undiagnosed and untreated (Centers for Disease Control and Prevention [CDC], 2011). More than 1 in 5 health care dollars in the U.S. goes to the care of people with diagnosed diabetes, costing $245 billion dollars annually.
  • The benefits of a multifactorial approach to diabetes care are supported by the results of the Steno 2 Study of 160 patients with type 2 diabetes mellitus (T2DM) and microalbuminuria. Multifactorial interventions achieved a 50% reduction in mortality and significant reduction in microvascular complications five years after ending a 7.8-year multifactorial intervention that achieved glycated hemoglobin (A1c) of 7.8%, low-density lipoprotein (LDL) 83 mg/dL, blood pressure (BP) 131/73, compared to a conventional group that achieved A1c 9%, LDL 126 mg/dL and BP 146/78 (Gaede et al., 2008). Results of this study are consistent with the need for reasonable blood glucose control with emphasis on blood pressure and lipid management.
  • Hospitalized patients with diabetes suffer increased morbidity, mortality, length of stay, and other related hospital costs compared to non-hyperglycemic inpatients (Umpierrez et al., 2002).
  • Hyperglycemia has been associated with increased infection rates and poorer short-term and long-term outcomes in critically ill patients in the intensive care unit, post-myocardial infarction, and post-surgical settings (van den Berghe et al., 2001).
  • There is a substantial increase in the prevalence of depression among people with diabetes as compared to the general adult population (Anderson et al., 2001). Depression impacts the ability of a person with diabetes to achieve blood glucose control, which in turn impacts the rate of development of diabetes complications (de Groot et al., 2001; Lustman & Gavard, 2001).
  • Sleep apnea is a prevalent condition in obese patients with type 2 diabetes and is associated with significant comorbidities including hypertension, cardiovascular disease and insulin resistance.
  • Up to 21% of patients with T2DM are found to have retinopathy at the time of diagnosis of diabetes mellitus (Fong et al., 2004). Generally retinopathy progresses from mild background abnormalities to preproliferative retinopathy to proliferative retinopathy.
  • Achieving near-normal glycemic control lowers risk of diabetes microvascular complications such as retinopathy, nephropathy and amputations. Achieving A1c of 6.9 to 7.9% may also significantly reduce macrovascular complications based on Steno-2 and UK Prospective Diabetes Study (UKPDS) data (Hemmingsen et al., 2013; Callaghan et al., 2012; Anderson et al., 2011; Action to Control Cardiovascular Risk in Diabetes Study Group et al., 2008; ACCORD Study Group et al., 2010; Ismail-Beigi et al., 2010; Duckworth et al., 2009; NICE-SUGAR Study Investigators et al., 2009; Ray et al., 2009; Turnbull et al., 2009; Abraira et al., 2009; ADVANCE Collaborative Group et al., 2008; Gaede et al., 2008; Holman et al., 2008).
  • Tobacco smoking increases risk of macrovascular complications 4% to 400% in adults with T2DM and also increases risk of macrovascular complications. Tobacco cessation is very likely to be the single most beneficial intervention that is available, and it should be emphasized by clinicians.
  • Uncontrolled hypertension is a major cardiovascular risk factor that also accelerates the progression of diabetic nephropathy (Morrish et al., 1991).
  • Seventy to seventy-five percent of adult patients with diabetes die of macrovascular disease, specifically coronary, carotid and/or peripheral vascular disease. In most patients with diabetes, use of a statin can reduce major vascular events.

Evidence for Additional Information Supporting Need for the Measure

Abraira C, Duckworth WC, Moritz T, VADT Group. Glycaemic separation and risk factor control in the Veterans Affairs Diabetes Trial: an interim report. Diabetes Obes Metab. 2009 Feb;11(2):150-6. PubMed External Web Site Policy

ACCORD Study Group, ACCORD Eye Study Group, Chew EY, Ambrosius WT, Davis MD, Danis RP, Gangaputra S, Greven CM, Hubbard L, Esser BA, Lovato JF, Perdue LH, Goff DC, Cushman WC, Ginsberg HN, Elam MB, Genuth S, Gerstein HC, Schubart U, Fine LJ. Effects of medical therapies on retinopathy progression in type 2 diabetes. N Engl J Med. 2010 Jul 15;363(3):233-44. PubMed External Web Site Policy

Action to Control Cardiovascular Risk in Diabetes Study Group, Gerstein HC, Miller ME, Byington RP, Goff DC Jr, Bigger JT, Buse JB, Cushman WC, Genuth S, Ismail-Beigi F, Grimm RH Jr, Probstfield JL, Simons-Morton DG, Friedewald WT. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008 Jun 12;358(24):2545-59. PubMed External Web Site Policy

ADVANCE Collaborative Group, Patel A, MacMahon S, Chalmers J, Neal B, Billot L, Woodward M, Marre M, Cooper M, Glasziou P, Grobbee D, Hamet P, Harrap S, Heller S, Liu L, Mancia G, Mogensen CE, Pan C, Poulter N, Rodgers A, Williams B, Bompoint S, de Galan BE, Joshi R, Travert F. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008 Jun 12;358(24):2560-72. PubMed External Web Site Policy

Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care. 2001 Jun;24(6):1069-78. PubMed External Web Site Policy

Anderson RT, Narayan KM, Feeney P, Goff D Jr, Ali MK, Simmons DL, Sperl-Hillen JA, Bigger T, Cuddihy R, O'Conner PJ, Sood A, Zhang P, Sullivan MD, Action to Control Cardiovascular Risk in Diabetes (ACCORD) Investigators. Effect of intensive glycemic lowering on health-related quality of life in type 2 diabetes: ACCORD trial. Diabetes Care. 2011 Apr;34(4):807-12. PubMed External Web Site Policy

Callaghan BC, Little AA, Feldman EL, Hughes RA. Enhanced glucose control for preventing and treating diabetic neuropathy. Cochrane Database Syst Rev. 2012;6:CD007543. PubMed External Web Site Policy

Centers for Disease Control and Prevention (CDC). National diabetes fact sheet, 2011: fast facts on diabetes. Atlanta (GA): Centers for Disease Control and Prevention (CDC); 2011.

de Groot M, Anderson R, Freedland KE, Clouse RE, Lustman PJ. Association of depression and diabetes complications: a meta-analysis. Psychosom Med. 2001 Jul-Aug;63(4):619-30. PubMed External Web Site Policy

Duckworth W, Abraira C, Moritz T, Reda D, Emanuele N, Reaven PD, Zieve FJ, Marks J, Davis SN, Hayward R, Warren SR, Goldman S, McCarren M, Vitek ME, Henderson WG, Huang GD, VADT Investigators. Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med. 2009 Jan 8;360(2):129-39. PubMed External Web Site Policy

Fong DS, Aiello L, Gardner TW, King GL, Blankenship G, Cavallerano JD, Ferris FL 3rd, Klein R. Retinopathy in diabetes. Diabetes Care. 2004 Jan;27(Suppl 1):S84-7. [10 references] PubMed External Web Site Policy

Gaede P, Lund-Andersen H, Parving HH, Pedersen O. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 2008 Feb 7;358(6):580-91. PubMed External Web Site Policy

Hemmingsen B, Lund SS, Gluud C, Vaag A, Almdal TP, Hemmingsen C, Wetterslev J. Targeting intensive glycaemic control versus targeting conventional glycaemic control for type 2 diabetes mellitus. Cochrane Database Syst Rev. 2013;11:CD008143. PubMed External Web Site Policy

Holman RR, Paul SK, Bethel MA, Neil HA, Matthews DR. Long-term follow-up after tight control of blood pressure in type 2 diabetes. N Engl J Med. 2008 Oct 9;359(15):1565-76.

Ismail-Beigi F, Craven T, Banerji MA, Basile J, Calles J, Cohen RM, Cuddihy R, Cushman WC, Genuth S, Grimm RH, Hamilton BP, Hoogwerf B, Karl D, Katz L, Krikorian A, O'Connor P, Pop-Busui R, Schubart U, Simmons D, Taylor H, Thomas A, Weiss D, Hramiak I, ACCORD trial group. Effect of intensive treatment of hyperglycaemia on microvascular outcomes in type 2 diabetes: an analysis of the ACCORD randomised trial. Lancet. 2010 Aug 7;376(9739):419-30. PubMed External Web Site Policy

Lustman PJ, Gavard JA. Psychosocial aspects of diabetes in adult populations. In: National Diabetes Data Group. Diabetes in America. 2nd ed. Bethesda (MD): National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 1995. p. 507-18.

Morrish NJ, Stevens LK, Fuller JH, Jarrett RJ, Keen H. Risk factors for macrovascular disease in diabetes mellitus: the London follow-up to the WHO Multinational Study of Vascular Disease in Diabetics. Diabetologia. 1991 Aug;34(8):590-4. PubMed External Web Site Policy

NICE-SUGAR Study Investigators, Finfer S, Chittock DR, Su SY, Blair D, Foster D, Dhingra V, Bellomo R, Cook D, Dodek P, Henderson WR, Hebert PC, Heritier S, Heyland DK, McArthur C, McDonald E, Mitchell I, Myburgh JA, Norton R, Potter J, Robinson BG, Ronco JJ. Intensive versus conventional glucose control in critically ill patients. N Engl J Med. 2009 Mar 26;360(13):1283-97. PubMed External Web Site Policy

Ray KK, Seshasai SR, Wijesuriya S, Sivakumaran R, Nethercott S, Preiss D, Erqou S, Sattar N. Effect of intensive control of glucose on cardiovascular outcomes and death in patients with diabetes mellitus: a meta-analysis of randomised controlled trials. Lancet. 2009 May 23;373(9677):1765-72. PubMed External Web Site Policy

Redmon B, Caccamo D, Flavin P, Michels R, O'Connor P, Roberts J, Smith S, Sperl-Hillen J. Diagnosis and management of type 2 diabetes mellitus in adults. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2014 Jul. 85 p. [197 references]

Turnbull FM, Abraira C, Anderson RJ, Byington RP, Chalmers JP, Duckworth WC, Evans GW, Gerstein HC, Holman RR, Moritz TE, Neal BC, Ninomiya T, Patel AA, Paul SK, Travert F, Woodward M, Control Group. Intensive glucose control and macrovascular outcomes in type 2 diabetes. Diabetologia. 2009 Nov;52(11):2288-98. PubMed External Web Site Policy

Umpierrez GE, Isaacs SD, Bazargan N, You X, Thaler LM, Kitabchi AE. Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab. 2002 Mar;87(3):978-82. PubMed External Web Site Policy

van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Bouillon R. Intensive insulin therapy in the critically ill patients. N Engl J Med. 2001 Nov 8;345(19):1359-67. PubMed External Web Site Policy

Extent of Measure Testing

Unspecified

National Guideline Clearinghouse Link

Diagnosis and management of type 2 diabetes mellitus in adults. External Web Site Policy

State of Use

Current routine use

Current Use

Internal quality improvement

Measurement Setting

Ambulatory/Office-based Care

Professionals Involved in Delivery of Health Services

Advanced Practice Nurses

Nurses

Physician Assistants

Physicians

Least Aggregated Level of Services Delivery Addressed

Clinical Practice or Public Health Sites

Statement of Acceptable Minimum Sample Size

Unspecified

Target Population Age

Age 18 to 75 years

Target Population Gender

Either male or female

National Quality Strategy Aim

Better Care

National Quality Strategy Priority

Prevention and Treatment of Leading Causes of Mortality

IOM Care Need

Living with Illness

IOM Domain

Effectiveness

Case Finding Period

The time frame pertaining to data collection is the past 12 months.

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Clinical Condition

Encounter

Patient/Individual (Consumer) Characteristic

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
Number of patients ages 18 to 75 years old who have type 2 diabetes mellitus (T2DM)

Data Collection: Data should be collected from electronic medical records (EMR) for all patient visits in the past 12 months.

Exclusions
Unspecified

Exclusions/Exceptions

Unspecified

Numerator Inclusions/Exclusions

Inclusions
Number of patients who achieve all of the following control criteria:

  1. Glycated hemoglobin (HgbA1c) less than 8%
  2. Most recent blood pressure measurement less than 140/90 mmHg
  3. Tobacco free
  4. Established atherosclerotic cardiovascular disease (ASCVD) with documented daily aspirin use (unless contraindicated)
  5. Ages 40 to 75 years with type 2 diabetes mellitus (T2DM) and untreated low-density lipoprotein (LDL) greater than 70 mg/dL who are prescribed statin therapy

Exclusions
Unspecified

Numerator Search Strategy

Fixed time period or point in time

Data Source

Electronic health/medical record

Type of Health State

Physiologic Health State (Intermediate Outcome)

Instruments Used and/or Associated with the Measure

Unspecified

Measure Specifies Disaggregation

Measure is disaggregated into categories based on different definitions of the denominator and/or numerator

Basis for Disaggregation

This measure is disaggregated based on different definitions of the denominator and numerator. This measure should be calculated as both an individual component met and a composite (all components met at the same time) measure.

Denominators:

  1. Number of patients ages 18 to 75 years old who have type 2 diabetes mellitus (T2DM)
  2. Number of patients ages 18 to 75 years old who have T2DM
  3. Number of patients ages 18 to 75 years old who have T2DM
  4. Number of patients ages 18 to 75 years old who have T2DM and established atherosclerotic cardiovascular disease (ASCVD)
  5. Number of patients ages 40 to 75 years old who have T2DM and untreated low-density lipoprotein (LDL) greater than 70 mg/dL
  6. Number of patients ages 18 to 75 years old who have T2DM

Numerators:

  1. Number of patients with glycated hemoglobin (HgbA1c) less than 8%
  2. Number of patients with most recent blood pressure measurement less than 140/90 mmHg
  3. Number of patients who are tobacco free
  4. Number of patients with established ASCVD with documented daily aspirin use (unless contraindicated)
  5. Number of patients ages 40 to 75 years with type 2 diabetes and untreated LDL greater than 70 mg/dL who are prescribed statin therapy
  6. Number of patients with all of the above

Scoring

Composite/Scale

Rate/Proportion

Interpretation of Score

Desired value is a higher score

Allowance for Patient or Population Factors

Unspecified

Standard of Comparison

Internal time comparison

Original Title

Diabetes optimal care.

Measure Collection Name

Diagnosis and Management of Type 2 Diabetes Mellitus in Adults

Submitter

Institute for Clinical Systems Improvement - Nonprofit Organization

Developer

Institute for Clinical Systems Improvement - Nonprofit Organization

Funding Source(s)

The Institute for Clinical Systems Improvement's (ICSI's) work is funded by the annual dues of the member medical groups and five sponsoring health plans in Minnesota and Wisconsin.

Composition of the Group that Developed the Measure

Work Group Members: Bruce Redmon, MD (Work Group Leader) (University of Minnesota) (Endocrinology); David Caccamo, MD (HealthPartners Medical Group and Regions Hospital) (Family Medicine); Ryan Michels, PharmD, BCPS (HealthPartners Medical Group and Regions Hospital) (Pharmacy); Patrick O'Connor, MD (HealthPartners Medical Group and Regions Hospital) (Family Medicine); Julie Roberts, MS, RD, CDE (HealthPartners Medical Group and Regions Hospital) (Health Education); JoAnn Sperl-Hillen, MD (HealthPartners Medical Group and Regions Hospital) (Internal Medicine); Steve Smith, MD (Mayo Clinic) (Endocrinology); Penny Louise Flavin, DNP, RN, CNP (Olmsted Medical Center) (Family Practice); Cassie Myers (Institute for Clinical Systems Improvement [ICSI]) (Project Manager); Linda Setterlund, MA, CPHQ (ICSI) (Clinical Systems Improvement Facilitator)

Financial Disclosures/Other Potential Conflicts of Interest

The Institute for Clinical Systems Improvement (ICSI) has long had a policy of transparency in declaring potential conflicting and competing interests of all individuals who participate in the development, revision and approval of ICSI guidelines and protocols.

In 2010, the ICSI Conflict of Interest Review Committee was established by the Board of Directors to review all disclosures and make recommendations to the board when steps should be taken to mitigate potential conflicts of interest, including recommendations regarding removal of work group members. This committee has adopted the Institute of Medicine Conflict of Interest standards as outlined in the report Clinical Practice Guidelines We Can Trust (2011).

Where there are work group members with identified potential conflicts, these are disclosed and discussed at the initial work group meeting. These members are expected to recuse themselves from related discussions or authorship of related recommendations, as directed by the Conflict of Interest committee or requested by the work group.

The complete ICSI policy regarding Conflicts of Interest is available at the ICSI Web site External Web Site Policy.

Disclosure of Potential Conflicts of Interest

David Caccamo, MD (Work Group Member)
Family Physician, Family Medicine, HealthPartners Medical Group and Regions Hospital
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Penny Louise Flavin, DNP, RN, CNP (Work Group Member)
Family Practice, Olmsted Medical Center
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Ryan Michels, PharmD, BCPS (Work Group Member)
Clinical Pharmacist, HealthPartners Medical Group and Regions Hospital
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Patrick O'Connor, MD (Work Group Member)
Family Medicine/Geriatrics, Senior Clinical Investigator, HealthPartners Medical Group and Regions Hospital
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: Lipid Management in Adults, Diagnosis and Treatment of Hypertension
Research Grants: Received institutional payment for research grants from NIH (National Institutes of Health), AHRQ (Agency for Healthcare Research and Quality, NIMH (National Institute of Mental Health), NHLBI (National Heart, Lung and Blood Institute) and to develop standards of diabetes care for American Diabetes Association
Financial/Non-Financial Conflicts of Interest: None

Bruce Redmon, MD (Work Group Member)
Endocrinology, Professor, University of Minnesota Medical School
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: None
Research Grants: NIH (National Institutes of Health) related to ongoing diabetes clinical trial, including the Look Ahead study and GRADE study
Financial/Non-Financial Conflicts of Interest: Consults for the University of Minnesota and Optum Insight and is paid directly to the physician's employer

Julie Roberts, MS, RD, CDE (Work Group Member)
Registered Dietician, HealthPartners Medical Group and Regions Hospital
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Steve Smith, MD (Work Group Member)
Endocrinology, Consultant, Medical Director of Patient Education, Mayo Clinic
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

JoAnn Sperl-Hillen, MD (Work Group Member)
Internal Medicine, Investigator, HealthPartners Medical Group and Regions Hospital
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: Has served on guideline group for BMJ Online T2DM guideline
Research Grants: Receives programmatic support paid to her institution for the following: Stimulated Diabetes Training for Resident Physicians (NIDDK funded), Primary investigator; Personalized Physician Learning for HTN (NHLBI), co-investigator; Priorities (NHLBI), co-investigator; Hyperlink (NHLBI), co-investigator; travel and expenses paid for by an educational grant from Sanofi through the International Diabetes Center
Financial/Non-Financial Conflicts of Interest: None

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2014 Jul

Measure Maintenance

Scientific documents are revised every 12 to 24 months as indicated by changes in clinical practice and literature.

Date of Next Anticipated Revision

The next scheduled revision will occur within 24 months.

Measure Status

This is the current release of the measure.

This measure updates a previous version: Riethof M, Flavin PL, Lindvall B, Michels R, O'Connor P, Redmon P, Retzer K, Roberts J, Smith S, Sperl-Hillen J, Institute for Clinical Systems Improvement (ICSI). Diagnosis and management of type 2 diabetes mellitus in adults. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2012 Apr. 141 p.

The measure developer reaffirmed the currency of this measure in January 2016.

Source(s)

Redmon B, Caccamo D, Flavin P, Michels R, O'Connor P, Roberts J, Smith S, Sperl-Hillen J. Diagnosis and management of type 2 diabetes mellitus in adults. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2014 Jul. 85 p. [197 references]

Measure Availability

Source available for purchase from the Institute for Clinical Systems Improvement (ICSI) Web site External Web Site Policy. Also available to ICSI members for free at the ICSI Web site External Web Site Policy and to Minnesota health care organizations free by request at the ICSI Web site External Web Site Policy.

For more information, contact ICSI at 8009 34th Avenue South, Suite 1200, Bloomington, MN 55425; Phone: 952-814-7060; Fax: 952-858-9675; Web site: www.icsi.org External Web Site Policy; E-mail: icsi.info@icsi.org.

NQMC Status

This NQMC summary was completed by ECRI Institute on May 6, 2013.

This NQMC summary was updated by ECRI Institute on January 5, 2015.

The information was reaffirmed by the measure developer on January 13, 2016.

Copyright Statement

This NQMC summary (abstracted Institute for Clinical Systems Improvement [ICSI] Measure) is based on the original measure, which is subject to the measure developer's copyright restrictions.

The abstracted ICSI Measures contained in this Web site may be downloaded by any individual or organization. If the abstracted ICSI Measures are downloaded by an individual, the individual may not distribute copies to third parties.

If the abstracted ICSI Measures are downloaded by an organization, copies may be distributed to the organization's employees but may not be distributed outside of the organization without the prior written consent of the Institute for Clinical Systems Improvement, Inc.

All other copyright rights in the abstracted ICSI Measures are reserved by the Institute for Clinical Systems Improvement, Inc. The Institute for Clinical Systems Improvement, Inc. assumes no liability for any adaptations or revisions or modifications made to the abstracts of the ICSI Measures.

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