Diabetes: IFCC-HbA1c 58mmol/mol or less

  • NICE indicator
  • IND165
  • Published:
  • Last updated:
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Indicator

The percentage of patients with diabetes, on the register, in whom the last IFCC-HbA1c is 58 mmol/mol or less in the preceding 12 months.

Indicator type

General practice indicator suitable for use in the Quality and Outcomes Framework.

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

Optimal blood glucose control is associated with a reduction in diabetes complications. An individual target for IFCC-HbA1c levels should be set to balance the benefits with harms.

For the purposes of primary care indicators, 3 separate clinical practice targets were adopted: HbA1c 58, 64 and 75 mmol/mol (IND164, IND135 and IND136). These targets are higher than the lower level recommended by the guidance, which may not be achievable or appropriate for all people. The 3 indicators aim to improve blood glucose control across the distribution of HbA1c values in the population with type 1 and type 2 diabetes.

Source guidance

Type 1 diabetes in adults: diagnosis and management. NICE guideline NG17 (2015, updated 2022), recommendations 1.6.6 and 1.6.9

Type 2 diabetes in adults: management. NICE guideline NG28 (2015, updated 2022), recommendations 1.6.8 and 1.6.9

Specification

Numerator: The number of patients in the denominator in whom the last IFCC-HbA1c is 58 mmol/mol or less in the preceding 12 months.

Denominator: The number of patients with diabetes, on the register.

Calculation: Numerator divided by the denominator, multiplied by 100.

Exclusions:

  • patients who had measurement of serum fructosamine instead of HbA1c in previous 12 months

  • patients who have a blood test exception code recorded in the preceding 12 months

  • patients who are on maximum tolerated diabetes treatment in the preceding 12 months

Minimum population: The indicator would be appropriate to assess performance at individual general practice level.

ISBN: 978-1-4731-6013-2