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Publications and Products
Publications and Products
Fact Sheet
A Diabetes Report Card for the United States
Quality of Care in the 1990s
This report is also provided in 
Portable Document Format
(PDF — 598 KB) - Learn more about PDFs.
Millions of diabetes patients may not be receiving optimal care for their
disease. Researchers at the Centers for Disease Control and Prevention
(CDC) developed a Diabetes Report Card to assess quality of diabetes care
in the United States. The Report Card was published in the April 2002
Annals of Internal Medicine.
Diabetes Report Card
- 18 percent of diabetes patients aged 18 to 75 years had poor glycemic
control (higher than 9.5 percent) and 34 percent had high blood pressure
(140/90 and higher).
Both are health conditions that if left untreated, can lead to serious
and often life-threatening complications for people with diabetes.
- 45 percent of diabetes patients had not received a foot examination
during the previous year and 37 percent had not been given a dilated-eye
examination. Diabetes is a leading cause of nontraumatic lower limb
amputations and blindness.
- Health insurance, insulin use, and race were associated with diabetes
care. Not having health insurance resulted in a poorer level of care,
and uninsured adults reported greater unmet health needs than insured
adults. Marked racial and ethnic differences were reported in health
insurance coverage and the risk of developing complications.
- Complications are more likely among persons using insulin, but insulin
users were more likely to receive preventive care.
- Flu vaccinations and dental examinations are also important indicators
of diabetes care and may be added to the Diabetes Quality Improvement
Project (DQIP) measures in the future. Only 58 percent of diabetes patients
visited a dentist in the past year.
Diabetes Quality Improvement Project
- The Report Card is the first report on quality of diabetes care using
a set of standard measures to document levels of diabetes care. The
standards were developed by the DQIP (www.NCQA.org) in response to a
growing need to deliver high quality diabetes care while keeping costs
under control.
- The DQIP 1.0 classifies indicators into three categories: accountability
indicators, quality improvement indicators, and indicators under field-testing.
The accountability measures include the following:
- A1C testing and levels
- Lipid testing and low-density lipoprotein (LDL) level
- Blood pressure levels
- Nephropathy assessment
- Eye exam
- Foot exam
- Data from the Behavioral Risk Factor Surveillance System 1995 (BRFSS)
and National Health and Nutrition Examination Survey (NHANES) 1988-1994
will serve as national benchmarks to monitor changes in the quality
of diabetes care and compare diabetes care in both public and private
health care systems.
Diabetes Facts
- Approximately a million new cases of diabetes are diagnosed each year
among people aged 20 years and older. Most (90 percent to 95 percent)
are type 2 diabetes, formerly called adult onset.
- Older age, physical inactivity, obesity, and family history are the
main risk factors for type 2 diabetes.
- Type 1 diabetes, or juvenile diabetes, comprises only about 5 percent
to 10 percent of cases and is not associated with lifestyle. Data used
in the Diabetes Report Card did not distinguish between type 1 and type
2 diabetes.
Related Link
Saaddine JB, Engelgau MM, Beckles GL, Gregg EW, Thompson TJ, Narayan
KM. A
diabetes report card for the United States: quality of care in the 1990s.
Ann Intern Med 2002 Apr 16;136(8):565-74.
For More Information
To learn more about diabetes, visit the CDC web site: http://www.cdc.gov/diabetes
or call toll free 1-800-CDC-INFO
1-888-232-6348 TTY .
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Page last reviewed: July 12, 2007
Page last modified: December 20, 2005
Content Source: National Center for Chronic Disease Prevention and Health Promotion
Division of Diabetes Translation
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Diabetes & Me