This measure assesses the percentage of members 18–75 years of age with diabetes (types 1 and 2) whose most recent glycemic status (hemoglobin A1c [HbA1c] or glucose management indicator [GMI]) was at the following levels during the measurement year:
- Glycemic status <8.0%.
- Glycemic status >9.0%.
Why It Matters
Diabetes is one of the most costly and highly prevalent chronic diseases in the United States (U.S.). Approximately 38 million U.S. adults have diabetes; 8.7 million of these cases are undiagnosed. Complications from the disease cost the country nearly $413B annually.1 Diabetes is the eighth leading cause of death in the U.S., and killed approximately 103,294 people in 2021.2 Many complications such as heart disease, stroke, blindness, kidney failure and amputation can be prevented if diabetes is detected and addressed in the early stages.
Glycemic control is management of blood sugar levels to reduce the risk of microvascular complications (eye, kidney and nerve diseases). The American Diabetes Association (ADA) recommends assessing glycemic status with HbA1c measurement or GMI using continuous glucose monitoring (CGM) data from a CGM device worn by a patient for at least 14 days. The ADA also recommends standardized reports from CGM devices, such as the ambulatory glucose profile. Guidance for interpreting CGM data, including GMI, is included in the ADA guidelines.
Historical Results – National Averages
Hemoglobin A1c Control for Patients With Diabetes - HbA1c Control (<8%)
| Measurement Year | Commercial HMO | Commercial PPO | Medicaid HMO | Medicare HMO | Medicare PPO |
|---|---|---|---|---|---|
| 2023 | 63.5 | 56.7 | 55.4 | 71.9 | 72.5 |
| 2022 | 61.8 | 53.8 | 50.9 | 68.5 | 69.7 |
| 2021 | 59.2 | 49.9 | 48.3 | 66.5 | 69 |
| 2020 | 53.2 | 48.4 | 45.0 | 62.9 | 67.1 |
| 2019 | 58.9 | 48.9 | 49.5 | § | § |
| 2018 | 58.2 | 51.1 | 48.7 | 66.1 | 68.4 |
| 2017 | 57.6 | 47.9 | 49.4 | 64.4 | 67.2 |
| 2016 | 56.0 | 46.6 | 47.1 | 62.9 | 66.3 |
| 2015 | 55.3 | 46.6 | 45.5 | 62.7 | 63.8 |
| 2014 | 57.5 | 52.6 | 46.5 | 64.8 | 65.2 |
| 2013 | 58.9 | 52.8 | 45.5 | 65.5 | 64.1 |
| 2012 | 61.3 | 54.5 | 46.5 | 64.3 | 62.8 |
| 2011 | 61.2 | 55.2 | 48.1 | 65.2 | 63.2 |
| 2010 | 62.3 | 50.2 | 46.9 | 65.6 | 57.3 |
| 2009 | 61.6 | 48.0 | 45.7 | 63.7 | 51.8 |
Hemoglobin A1c Control for Patients With Diabetes - Poor HbA1c Control
| Measurement Year | Commercial HMO | Commercial PPO | Medicaid HMO | Medicare HMO | Medicare PPO |
|---|---|---|---|---|---|
| 2023 | 27.7 | 35 | 35.8 | 18.6 | 18.6 |
| 2022 | 28.5 | 36.6 | 40.3 | 21.9 | 21.8 |
| 2021 | 30.7 | 42.5 | 42.3 | 23.5 | 21.7 |
| 2020 | 37.5 | 43.9 | 45.4 | 27.4 | 23.4 |
| 2019 | 29.8 | 40.1 | 40.4 | § | § |
| 2018 | 30.3 | 37.8 | 41.2 | 22.5 | 19.9 |
| 2017 | 31.7 | 41.2 | 40.5 | 25.4 | 22.3 |
| 2016 | 33.0 | 42.5 | 43.3 | 26.3 | 23.3 |
| 2015 | 33.8 | 44.3 | 45.4 | 27.4 | 26.5 |
| 2014 | 31.1 | 37.3 | 43.6 | 24.9 | 24.9 |
| 2013 | 30.5 | 37.7 | 45.6 | 25.3 | 26.6 |
| 2012 | 28.5 | 35.2 | 44.7 | 27.1 | 29.3 |
| 2011 | 28.3 | 33.5 | 43.0 | 26.5 | 28.8 |
| 2010 | 27.3 | 46.6 | 44.0 | 25.9 | 35.2 |
| 2009 | 28.2 | 44.6 | 44.9 | 28.0 | 41.3 |
| 2008 | 28.4 | 74.4 | 44.8 | 29.4 | 67.0 |
| 2007 | 29.4 | 84.1 | 48.0 | 29.0 | 74.7 |
| 2006 | 29.6 | 75.9 | 48.7 | 27.3 | 71.8 |
| 2005 | 29.7 | 55.4 | 49.2 | 23.6 | 27.3 |
| 2004 | 30.7 | – | 48.6 | 22.3 | – |
| 2003 | 32.0 | – | 48.6 | 23.4 | – |
| 2002 | 33.9 | – | 48.9 | 48.9 | – |
| 2001 | 36.9 | – | 48.3 | 26.8 | – |
| 2000 | 42.5 | – | – | – | – |
| 1999 | 44.9 | – | – | – | – |
REFERENCES
- Centers for Disease Control and Prevention (CDC). 2023. Diabetes Fast Facts. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services. https://www.cdc.gov/diabetes/basics/quick-facts.html
- Centers for Disease Control and Prevention (CDC). 2023. National Diabetes Statistics Report. Atlanta, GA: US Dept of Health and Human Services. https://www.cdc.gov/diabetes/data/statistics-report/index.html
- American Diabetes Association (ADA). 2024. “6. Glycemic Goals and Hypoglycemia: Standards of Care in Diabetes—2024.” Diabetes Care 2024 47(Suppl. 1):S111–S125. https://doi.org/10.2337/dc23-S006
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