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Type 2 diabetes in adults: management [NG28]

Measuring the use of this guidance

Recommendation: 1.2.1

Offer structured education to adults with type 2 diabetes and/or their family members or carers (as appropriate) at and around the time of diagnosis, with annual reinforcement and review. Explain to people and their carers that structured education is an integral part of diabetes care. [2009]

What was measured: Proportion of people with type 2 and other diabetes offered structured education within one year of diagnosis.
Data collection end: March 2012
9.8%
Data collection end: March 2013
11.8%
Data collection end: March 2014
15.8%
Data collection end: March 2015
53.8%
Data collection end: March 2016
69%
Data collection end: March 2017
76.6%
Area covered: National
Source: NHS Digital. National Diabetes Audit.

What was measured: DM014: The percentage of patients newly diagnosed with diabetes, on the register, in the preceding 1 April to 31 March who have a record of being referred to a structured education programme within 9 months after entry on to the diabetes register.
Data collection end: March 2015
66.27%
Data collection end: March 2016
71.1%
Data collection end: March 2017
69.6%
Area covered: National
Source: Health and Social Care Information Centre. Quality and Outcomes Framework.


Recommendation: 1.4.1

Measure blood pressure at least annually in an adult with type 2 diabetes without previously diagnosed hypertension or renal disease. Offer and reinforce preventive lifestyle advice. [2009]

What was measured: Proportion of people aged 12 or over with type 2 and other diabetes who had their blood pressure checked within the last year.
Data collection end: March 2015
96.1%
Data collection end: March 2016
95.7%
Data collection end: March 2017
96.2%
Area covered: National
Source: NHS Digital. National Diabetes Audit.


Recommendation: 1.4.6

Monitor blood pressure every 1–2 months, and intensify therapy if the person is already on antihypertensive drug treatment, until the blood pressure is consistently below 140/80 mmHg (below 130/80 mmHg if there is kidney, eye or cerebrovascular damage). [2009]

What was measured: Proportion of people with type 2 or other diabetes whose most recent blood pressure measurement was below 140/80 mmHg.
Data collection end: March 2012
66.6%
Data collection end: March 2013
68.6%
Data collection end: March 2014
73.6%
Data collection end: March 2015
74.2%
Data collection end: March 2016
73.6%
Data collection end: March 2017
74.2%
Area covered: National
Source: NHS Digital. National Diabetes Audit.


Recommendation: 1.6.1

"In adults with type 2 diabetes, measure HbA1c levels at: - 3–6-monthly intervals (tailored to individual needs), until the HbA1c is stable on unchanging therapy - 6-monthly intervals once the HbA1c level and blood glucose lowering therapy are stable. [2015]"

What was measured: Proportion of people with type 2 and other diabetes who had their HbA1c levels recorded in the previous year.
Data collection end: March 2015
94.8%
Data collection end: March 2016
95%
Data collection end: March 2017
95.1%
Area covered: National
Source: NHS Digital. National Diabetes Audit.


Recommendation: 1.6.7

For adults with type 2 diabetes managed either by lifestyle and diet, or by lifestyle and diet combined with a single drug not associated with hypoglycaemia, support the person to aim for an HbA1c level of 48 mmol/mol (6.5%). For adults on a drug associated with hypoglycaemia, support the person to aim for an HbA1c level of 53 mmol/mol (7.0%). [new 2015]

What was measured: Proportion of people with type 2 or other diabetes who achieved an HbA1c target of 48mmol/mol or lower in the previous year.
Data collection end: March 2016
28.2%
Number that met the criteria: 603836 / 2141028
Data collection end: March 2017
30.6%
Number that met the criteria: 791445 / 2588170
Area covered: National
Source: NHS Digital. National Diabetes Audit.


Recommendation: 1.7.14

Assess, educate and support men with type 2 diabetes who have problematic erectile dysfunction, addressing contributory factors such as cardiovascular disease as well as possible treatment options. [2015]

What was measured: Proportion of male patients with diabetes, on the register, who have a record of erectile dysfunction, with a record of advice and assessment of contributory factors and treatment options in the preceding 12 months.
Data collection end: March 2018
32.1%
Number that met the criteria: 20690 / 64362
Area covered: England
Source: Indicators no longer in QOF (INLIQ)


Recommendation: 1.7.17

On diagnosis, GPs should immediately refer adults with type 2 diabetes to the local eye screening service. Perform screening as soon as possible and no later than 3 months from referral. Arrange repeat structured eye screening annually.

What was measured: Proportion of those offered a routine diabetic eye screening appointment who attend and complete a routine digital screening encounter/event.
Data collection end: March 2017
82.4%
Number that met the criteria: 2257124 / 2738743
Area covered: England
Source: Public Health England. Diabetic eye screening

What was measured: Proportion of new additions to the service register who are offered an appointment within 3 months of notification to the service.
Data collection end: March 2017
95.8%
Number that met the criteria: 277267 / 289553
Area covered: England
Source: Public Health England. Diabetic eye screening



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