Diabetes: annual care processes
Indicator
The proportion of adults with diabetes who have received all 9 basic care processes.
Indicator type
Network / system level indicator.
The indicator would be appropriate to understand and report on the performance of networks or systems of providers.
This document does not represent formal NICE guidance. For a full list of NICE indicators, see our menu of indicators.
To find out how to use indicators and how we develop them, see our NICE indicator process guide.
Rationale
Key care processes to monitor and manage diabetes can help people with diabetes to manage their condition and reduce the risk of complications. These care processes are: HbA1c to test glucose control, blood pressure, serum cholesterol, body mass index (BMI) and smoking history (as measurements of cardiovascular risk), serum creatinine and urine albumin/creatinine ratio to test renal function, examination of foot ulcer risk and digital retinal screening for early detection of eye disease.
Source guidance
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Hypertension in adults: diagnosis and management. NICE guideline NG136 (2019, updated 2023), recommendations 1.2.11 and 1.4.15
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Type 1 diabetes in adults: diagnosis and management. NICE guideline NG17 (2015, updated 2022), recommendations 1.13.2, 1.13.5 and 1.15.5
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Type 2 diabetes in adults: management. NICE guideline NG28 (2015, updated 2022), recommendations 1.6.1 and 1.8.25
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Diabetic foot problems: prevention and management. NICE guideline NG19 (2015, updated 2019), recommendations 1.3.3, 1.3.7 and 1.3.11
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Chronic kidney disease in adults: assessment and management. NICE guideline NG203 (2021), recommendations 1.1.14 and 1.1.21
Specification
Numerator: The number in the denominator who receive all of the 9 basic care processes in the preceding 12 months:
Risk factors:
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blood pressure (systolic and diastolic blood pressure)
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HbA1c
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cholesterol levels
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BMI and weight
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smoking review.
Tests for early complications:
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foot exam
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eye screening (retinopathy screening)
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urinary albumin test (or protein test to measure renal function)
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blood creatinine (indicator for renal function).
Denominator: The number of people with diabetes.
Calculation: Numerator divided by the denominator, multiplied by 100.
Exclusions: None.
Data source: National Diabetes Audit (NDA).
Minimum population: The indicator would be appropriate to understand and report on the performance of networks or systems of providers.
ISBN: 978-1-4731-5872-6