Over 30M people in the U.S. have diabetes, and about 95% have type 2 diabetes.* Diabetes is the leading cause of kidney failure, amputation and blindness. It also significantly increases risk of heart disease and stroke.
Controlling blood sugar is key to living well with diabetes and avoiding serious complications. This means routinely measuring average blood sugar levels (HbA1c) and taking medications or insulin to maintain a safe range.
Yet, as Mayo Clinic researchers uncovered using OptumLabs® data, excessive testing and treatment of patients with diabetes can lead to unexpected harms. These insights have informed new quality measure development for safer, more personalized diabetes care.
Study 1: HbA1c overtesting
For most people with controlled type 2 diabetes, it’s suggested that they have their HbA1c tested 1-2 times per year to guide diabetes therapy. Yet more than half of such patients are tested more frequently than guidelines recommend.
The more doctors test, the more likely they are to add treatments to patient regimens despite their blood sugars already being in a good range. Is this safe?
Study 2: HbA1c overtreatment and hypoglycemia
One in five people with stable type 2 diabetes take too many blood sugar-lowering drugs. In older patients with other health problems, this can almost double their risk for severe hypoglycemia — dangerously low blood sugar that can require hospitalization and even be fatal.
New diabetes care quality measure development
Today, doctors are rewarded for keeping HbA1c from getting too high by using a one-size-fits-all approach. But when blood sugar gets too low, or when patients have to use many medications to keep HbA1c in the desired range, it’s also dangerous.
In collaboration with AARP and OptumLabs, the team is evolving a safer diabetes measure to help doctors find the “sweet spot” for each patient circumstance; considering the benefits and harms of each medication, and aiming for “better” not “lower” blood sugar levels.
Published research insights are disseminated widely and translated to improvements in care quality.
*Centers for Disease Control and Prevention. National Diabetes Statistics Report. Published July 17, 2017. Accessed Sept. 27, 2017.