What is high quality diabetes care?

 

Getting quality diabetes care means that certain health measures that are monitored in routine visits to your doctor's office meet standards that are known to lower the risk of serious complications. For diabetes, these include 
heart attack, stroke, amputation, blindness and loss of kidney function.

Quality care and standards for good control of diabetes include: 

► Blood sugar (glucose) control
► Blood pressure control
► Cholesterol control 
► Weight control (Body Mass Index "BMI") 
► Not smoking 
► Screening for kidney disease 
► Eye Examination 
► Vaccine to Prevent Pneumonia
 

A1C test and Blood Sugar Control

  Why it is important

To help manage your diabetes, it is important to keep your blood sugar level as close to normal as possible. This means that you need to get regular tests at the doctor's office to check your blood sugar. The test is called the Hemoglobin A1C test. It is a blood test that shows what your blood sugar level has been over the last three months. 

  What your doctor should do

Your doctor should give you the A1C test and talk to you about the results.

 How many people got the care they needed

. At 45 doctors' practices in Greater Cleveland that measure and report their care, 94% of their adult patients with diabetes had a least one A1C test in 2009. Across the region, 70% of diabetes patients had their blood sugar in good control.

 What you can do

Know your A1C measure. Ask you doctor if it is at a level that is right for you. If not, talk to your doctor about what you should do to lower it.

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 Blood pressure control

 Why it is important

People with diabetes may have high blood pressure. High blood pressure makes your heart work too hard. It can cause a heart attack, stroke or kidney disease. Having normal blood pressure can reduce your changes of having these serious problems.

 What your doctor should do

Your doctor should check your blood pressure at least at each office visit and discuss the results. Your blood pressure should be less than 140/80.

 How many people got the care they needed

In 2009, 52% of adults with diabetes who received their care in 45 medical practices in Greater Cleveland had their blood pressure under control.  

What you can do

If your blood pressure is too high, talk to your doctor about how it can be lowered using a combination of diet, exercise and medications. Medications can be very effective at lowering blood pressure. The two common kinds are called "ACE inhibitors" and "ARBs". Diet diet and exercise  is good for sugar control and also to keep your blood pressure at a safe level. 

 

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 Cholesterol Control

 Why it is important

There are two types of cholesterol: good and bad. "Bad" cholesterol can build up and block the flow of blood through your body. This can cause a heart attack or stroke. The medical term for bad cholesterol is LDL. Your LDL should be less than 100.

 What your doctor should do

Your doctor should give you a blood test at least once a year to check your cholesterol and talk to you about the results.

 How many people got the care they needed

Of adults with diabetes who had their cholesterol checked, 84% had their LDL "bad" cholesterol in good control or were taking a statin medication to help lower it.

  What you can do 

Talk to your doctor about getting your blood cholesterol checked and making sure that it's in control. If you LDL is too high, ask whether you should take a statin drug or how exercise and a healthy diet can help. 

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Weight control and Body Mass Index (BMI)

  Why it's important 

BMI is a measure of the amount of fat in your body, measured by your height and weight. If you have diabetes and high blood pressure, being overweight increases your risk for heart disease.
 

What your doctor should do

Your doctor should measure your BMI and talk to you about ways to lose weight if your BMI is too high. A BMI measurement between 25 and 29.9 means that you are overweight. A BMI that is 30 or higher means that you are obese.
 

How many people got the care they needed

In 2009, only 31% of adults in Northeast Ohio who have diabetes are not obese; that is, they have a BMI that is below 30. 
 

What you can do

If you are overweight, one of the best things you can do your health is lose weight. Talk to your doctor about how you can start and ask what help he or she can recommend.

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Not smoking

  Why it is important 

Everyone knows that smoking is bad for your health. For people with diabetes, it adds to the risk of serious complications. Smoking doubles your change of getting heart disease and raises your blood sugar.

  What your doctor should do 

 If you smoke, your doctor should talk to you about options to help you quit.
 

How many people got the care they needed?

In 2009, 79% of adults with diabetes in Northeast Ohio were not smoking.

    What you can do

Stop smoking. Ask your doctor about classes, medications and other tools to help you quit.

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Urine test to check for kidney disease

  Why it is important

Diabetes can cause your kidneys to stop working. If you have diabetes, you need to get a urine test to check for kidney problems. This test can let you and your doctor know if you need to take steps to keep your kidneys working. If your kidneys fail, you have to have your blood filtered through a machine (dialysis) every few days, or get a kidney transplant.
 

What your doctor should do
 

Your doctor should give you a urine test once a year to check for kidney problems and talk to you about the results.  

How many people got the care they needed

 In 2009, 91% of adults with diabetes got a urine test to check their kidneys or were prescribed an ACE-inhibitor or ARB medication to help.
 

What you can do

Ask your doctor about your kidney function and be sure you are tested at least once a year. All the things you do to manage your diabetes are important to protect your kidneys. These include exercise, eating right and keeping up with your medicines.

 

 

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Eye Examination

   Why it is important

People with diabetes may have high blood sugar levels. This can cause serious eye problems, such as trouble seeing and even blindness. A complete eye exam, where an eye doctor uses eye drops to dilate your pupils, is needed to detect any problems that are developing with your eyes.  
 

  What your doctor should do

Your doctor should refer you to an eye doctor and make sure you have a complete eye exam once a year to check for changes in your eyes.
 

How many people got the care they needed

In 2009, patients in 45 primary care practices had documented that 60% of adults with diabetes had a complete eye exam.  
 

What you can do

Make sure you make an appointment with an eye doctor every year. Ask your doctor to refer you one if you don't know any. If your vision changes, go to the eye doctor right away. Don't wait for your regular appointment. And keep your blood sugar in control!
 

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 Vaccination for pneumonia

 Why it is important 

 
People with diabetes are more likely to develop infections. If they get infections, they are more likely to do worse, because they have a bigger chance of complications. A pneumonia shot helps prevent pneumonia, which is an infection of the lungs, that is caused by certain bacteria.
 

  What your doctor should do

Your doctor should make sure you have had a shot to prevent pneumonia.
 

  How many people got the care they needed?

In 2009, 79% of patients with diabetes who received care at 45 medical practices in Greater Cleveland had received a vaccine to help prevent pneumonia. 
 

  What you can do

If you are not sure whether you ever got a pneumonia shot, ask your doctor at your next visit. And get one if you need it! You should have a flu shot every year.