The American Medical Association (AMA), Joint Commission on Accreditation of Healthcare Organizations (JCAHO), and the National Committee for Quality Assurance (NCQA) listed a set of performance measures that can be used to evaluate outpatient management of an adult patient with diabetes mellitus.


Frequency of office visits: variable, depending on the severity of the diabetes, the adequacy of control, duration and complications. A patient with well-controlled diabetes and no complications should be evaluated at least annually.


Clinical Examination:

(1) blood pressure monitoring and management

(2) foot examination

(3) eye examination


Laboratory testing:

(1) hemoglobin A1c measurement and use in guiding therapy

(2) serum lipid measurement and use in guiding therapy

(3) measurement of urine microalbumin and protein and use in guiding therapy


Additional interventions:

(1) appropriate immunizations (influenza, other)


Things not included that might be worth doing:

(1) Monitoring for peripheral vascular disease.

(2) Appropriateness of referrals to specialists.

(3) Monitoring of serum creatinine.

(4) Monitoring for autoimmune endocrinopathies in selected patients.

(5) Quality of diabetes education.

(6) Review of the patient's glucose records.

(7) Evaluating the quality of the drug regimens selected.


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