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2ndskiesforex indicators of diabetes

Back to Type 2 diabetes. Many people have type 2 diabetes without realising. This is because symptoms do not necessarily make you feel unwell. A GP can diagnose diabetes. You'll need a blood test, which you may have to go to your local health centre for if it cannot be done at your GP surgery. The earlier diabetes is diagnosed and treatment started, the better. Early treatment reduces your risk of other health problems. Age-adjustment is way to remove the effect of changing population age aging population or a population getting younger from the data.

Removing age allows us to say if numbers are going up or down over time because of factors that we are more likely to change. National adjusted incident ESRD rates increased through the s and s and then leveled off. Starting in , rates began to decline slightly. The pattern in the Minnesota data, shown above, is similar even though our graph only shows data from the last decade. Proportion of Minnesota adults with diabetes who complete foot examinations daily.

Importance of indicator This indicator was chosen to represent one of the important ways that people living with diabetes take care of themselves at home. Routine foot examination for sores and irritation is an important part of diabetes self-care. Why this indicator was chosen Regular foot examinations are important for detecting sores or irritations that can become infected and eventually lead to lower extremity amputations, a diabetes complication that has long lasting consequences on daily life.

This includes preventing sores by using appropriate footwear, educating people with diabetes and their health care providers about performing foot exams, and effectively treating any foot ulcers that are found. The BRFSS is a population-based self-reported telephone survey of health behaviors and conditions of resident Minnesotans 18 years of age and older.

Individuals in institutionalized settings like nursing homes or college dorms are not included. Include times when checked by a family member or friend, but do NOT include times when checked by a health professional. Overall results The proportion of Minnesota adults with diabetes who examine their feet for sores or irritation every day is Other relevant data for interpreting the indicator: Information about provider foot-checks:. The BRFSS survey also includes a separate question asking people with diabetes whether or not their health care provider performed a foot check during a clinic visit within the last year.

Both self-checks and provider checks are part of a comprehensive diabetes management strategy. That is why we present the other half of the story, what doctors completed, below for your reference. The Healthy People target for adults with diabetes reporting that their provider completed a food exam is Minnesota has reached this goal.

However, there is room for improvement. A person with diabetes should have a comprehensive foot exam by a provider each year to identify risk factors for foot ulcers and amputations. Percentage of Minnesota adults who have diabetes and are enrolled in fee-for-service Medicare who adhere to prescribed blood sugar medication.

Importance of indicator Correctly taking prescribed medication, which is known as medication adherence, is an important part of diabetes self-management for many adults with diabetes. It is important to look at the degree to which people take prescribed medications. There are many types of medications that people with diabetes take to manage their disease and to help prevent the development of complications.

A common medication taken is one that controls blood sugar. Why this indicator was chosen The indicator we chose looks at medication adherence for people with diabetes who take prescribed blood sugar medications and have Medicare fee-for-service insurance.

Since diabetes risk increases with age, looking at the Medicare population makes sense. This data only describe people who have Medicare fee-for-service insurance and not people who purchase Medicare Advantage managed care plans through private insurers. This means that we cannot describe all people with diabetes on Medicare.

The results apply to the Medicare population enrolled in fee-for-service Medicare. Measure Definition The measure includes adults 18 years of age and older who have been prescribed medications for controlling blood sugar To be included in this measure, adults with diabetes need to be taking one of the following medications used to control blood sugar: a biguanide, a sulfonylurea, a thiazolidinedione, a DPP-IV inhibitor, an incretin mimetic drug, a meglitinide drug or a SGLT2 inhibitor that regulates glucose.

Insulin is not included in the list of medications for this measure. There is a year lag between the claim being filed and data reporting. For example, data representing medication adherence during are included in the Star Ratings Data.

Rates are reported for each individual plan and an overall state rate is calculated. The state rate is the average of individual plan rates reported by Medicare plans servicing fee-for-service enrollees in Minnesota. This is not the average adherence among adults served by fee-for-service Medicare in Minnesota because we do not know the number of people with diabetes who are covered by each plan. Proportion of Minnesota adults with diagnosed diabetes enrolled in managed care insurance plans who have their kidney function checked.

Importance of indicator Kidney disease, or nephropathy, is a common and serious problem among people with diabetes. The most severe form of kidney disease end-stage renal disease [ESRD] is caused by diabetes or hypertension in 7 out of 10 people and requires dialysis or a kidney transplant. Maintaining good control of blood sugar and blood pressure can prevent kidney function from getting worse. Why this indicator was chosen This indicator is one of the measures that Minnesota health insurers need to report to the state.

Kidney damage cannot be treated appropriately if it is not diagnosed or routinely assessed. This indicator examines all people with diabetes and includes routine assessments for the prevention or treatment of kidney disease. Health insurance plans use this information to find out how health care can be improved.

HEDIS measures cover many different health topics including diabetes. Different insurers report data to different agencies. A limitation to this data is that it only describes a small fraction around 1 in 4 of Minnesotans with diabetes. Measure definition The data is presented for the year of service listed. In brief, the measure includes all year old adults with type 1 or type 2 diabetes who were enrolled in the reporting insurance plan for the whole calendar year. The measure reports the percentage of insured adults with diabetes who had either:.

For more information, please see refer to the National Quality Measures Clearinghouse: Comprehensive diabetes care: Percentage of members 18 to 75 years of age with diabetes type 1 and type 2 who received medical attention for nephropathy. The overall state average rate is calculated by taking a weighted average of each rate reported by all insurance plans that report to the Minnesota Department of Health. To determine rates by the type of health care plan, the weighted average of rates was then determined for all health plans that offered that particular type of coverage.

People included often belong to high risk groups such as; people with low incomes, elderly, and people with disabilities. This data can help us understand where improvements in screening rates are most needed in these groups. Percentage of Minnesota adults who do not have diabetes, but report that a health care provider told them they have prediabetes. Importance of indicator Recent estimates suggest around 1 in 3 U.

Adults with prediabetes are also more likely to develop other serious health conditions including cardiovascular disease, stroke, and kidney disease than people with normal blood sugars. National data show only about 1 in 10 adults with prediabetes knows that they have the condition. Why this indicator was chosen This measure shows what percentage of adults in the state know that they have prediabetes.

There is no other state-based dataset that can provide this type of estimate. Awareness of prediabetes is an important part of helping people with prediabetes take steps to reverse the condition or delay its progression to diabetes. Overall results Percentage of Minnesota adults who do not have diabetes, but report being told by a health care provider that they have prediabetes — 8.

This measure does not include adults who have prediabetes, but have not been told they have it nor does it include people who have not been diagnosed. National data suggests that the vast majority of adults with prediabetes are not aware of their condition. Trends in prevalence and control of diabetes in the United States, and Ann Intern Med 8 Percentage of births in Minnesota in which the mother had gestational diabetes.

This does not include women who had type 1 or type 2 diabetes before pregnancy. GDM is one of the most important risk factors for developing type 2 diabetes in the future. During pregnancy, GDM needs to be treated, either with lifestyle modifications or medications including insulin , to reduce risk of health problems for both mother and child. Additionally, children whose mothers had GDM during their pregnancy are at greater risk for obesity and possibly diabetes when they grow up.

Why this indicator was chosen There are multiple sources of data available to estimate the prevalence of GDM, each with their own limitations. Birth certificate data was chosen for this indicator because this data is the most recent, easily available, and because it is believed to be greatest representative of all Minnesota births. Data source The data were obtained from the Minnesota Center for Health Statistics and are derived from Minnesota birth certificate records.

Measure Definition Risk factors for pregnancy are documented on the birth certificate, including:. Overall Result Percentage of births in Minnesota in which the mother had gestational diabetes — 7. Additional data related to the indicator subgroup analyses : Older mothers have higher rates of gestational diabetes. Rates of gestational diabetes among Hispanic mothers are higher than the rates among Non-Hispanic mothers.

For historical trends related to diabetes-complicated pregnancies, please see Devlin et al. Trends and disparities among diabetes-complicated births in Minnesota, Am J Public Health. Other relevant data for interpreting the indicator: PRAMS was identified as an alternate data source. In addition to gestational diabetes, PRAMS also asks about diabetes that the mother had before the start of pregnancy.

Proportion of Minnesota adults who meet the following weekly guidelines for physical activity:. Importance of indicator Physical activity is important to help control weight, prevent and manage diabetes, reduce heart attacks and strokes, strengthen bones and muscles, improve mental health and moods, and it may help people to live longer.

The survey is a weighted population-based survey of health behaviors of adults residing in Minnesota. Based on individual responses to these questions, estimated average levels of aerobic physical activity and muscle strengthening activity per week were calculated. Overall result Proportion of Minnesota adults who meet the following weekly guidelines for physical activity:. Most Minnesota adults report engaging in some physical activity in the last 30 days not including their job — Additional data related to the indicator subgroup analyses :.

General Population: Older adults are less likely to reach overall physical activity targets, mostly because fewer people meet muscle strengthening activity guidelines. BRFSS data Overall, men and women meet physical activity goals at similar rates, however slightly more men achieve muscle strengthening goals.

Overall, it is difficult to assess whether there are significant differences in physical activity engagement between people from different racial and ethnic groups because the available race and ethnicity-specific rates are based on small numbers.

Adults with Diabetes: Adults living with diabetes are less likely to meet physical activity guidelines than adults who did not have diabetes. Physical activity rates for adults with diabetes did not differ by age Data not shown and are lower than rates for adults without diabetes at any age. Rates may be lower for people with diabetes for many reasons. Importance of indicator People living with diabetes have better health outcomes when they have access to medical care and when they have regular care with a particular provider or team.

This measure does tell us if people feel they have a personal doctor and it is easily available. Unfortunately, it does not tell us if a person sees this doctor. These are higher rates than reported by adults who do not have diabetes, especially men who do not have diabetes. Percentage of Minnesota adults with diabetes who report ever being diagnosed with depression.

Importance of indicator Mental health problems related to diabetes are very complex and important to address. People with mental health issues often have higher rates of diabetes and other chronic conditions. It is therefore important to identify depression among people living with diabetes and to ensure people have access to the help and services they need to be healthy. Overall result Percentage of Minnesota adults with diabetes who report ever being diagnosed with depression — Depression is more common among adults with diabetes than adults without diabetes.

Both men and women with diabetes tend to report a depression diagnosis more frequently than men and women who do not have diabetes. Adults under 65 years of age are more likely than older adults to report ever being diagnosed with depression. Also, for all age groups, adults who have diabetes are more likely to report ever being diagnosed with depression than adults without diabetes. Others have noted a differences in rates of reporting depression diagnoses by age groups. Other relevant data for interpreting the indicator: Studies examining treatment of people who have diabetes and depression show that treatment can make depression better.

A recent review of scientific papers on the subject found that some studies find a better A1c levels among people with diabetes who had their depression treated and some did not. Another reference to consider to learn more about differences in depression rates by age-group: Depression as a disease of modernity: explanations for increasing prevalence by BH Hidaka.

Percentage of Minnesota adults with diabetes who reported limitations to their usual activities for 7 or more days in the last month as a result of poor physical or mental health. This indicator is important because it tries to capture aspects of people's lives that are important to their everyday activities and living. Often groups of diabetes indicators focus on numbers such as how many people have diabetes, the cost of diabetes care, and diabetes management and leave out measures that begin to describe the quality of life for people with diabetes.

This measure was meant to be a first step in the direction of having a quality of life measure. Why this indicator was chosen This indicator captures the limitations on normal life activities caused by any health problem, physical or mental. Overall result Percentage of Minnesota adults with diabetes who reported limitations to their usual activities for 7 or more days in the last month as a result of poor physical or mental health — Adults living with diabetes are more than twice as likely to report limitations in their daily activities compared to people without diabetes.

Both men and women living with diabetes experience limitations to their daily activities more often than people who do not have diabetes. The uncertainty in the percentages make it hard to say exactly how much more common it is for adults with diabetes to experience these limitations. All adults with diabetes were more likely to experience limitations in daily activities than people without diabetes.

However the difference between people with diabetes and people without diabetes was bigger among younger adults. Blood Glucose Screening Rates Overall result Percentage of Minnesota adults between years of age who are overweight or obese, who do not have known diabetes, and who have been screened for diabetes in the last 3 years — People who said they were not screened represent two groups of people: People who did not get their blood glucose levels tested People who were tested, but either did not know or forgot about it at the time they were asked For more information about national screening rates according to criteria supported by the American Diabetes Association and other recommendations considered by the US Preventive Services Task Force, see Casagrande et al.

Adults Living with Diabetes 7. Overall result Percentage of Minnesota adults who report that a health care provider has told them that they have diabetes — 7. Paul 6. Other relevant data for interpreting the indicator: Type 1 or Type 2 diabetes: The BRFSS survey question does not ask respondents whether or not they have type 1 or type 2 diabetes. The prevalence of diagnosed diabetes nearly doubled between and in Minnesota.

Rates of Newly Diagnosed Diabetes 5. Increases in the number of people living with diabetes can happen for many reasons see Adults Living with Diabetes indicator above : People with diabetes may be living longer Better identification — we are doing a better job of finding people with undiagnosed diabetes that has been going on for some time, often years People are developing diabetes at a faster rate than before Data about the number of new diabetes cases can help us better understand if the number of people living with diabetes is increasing because of reasons stated above.

Additional data related to the indicator: Overall result The rate of new diabetes diagnoses in Minnesota adult population was 5. Increases in the overall number of people with diabetes may occur for many reasons: People with diabetes may be living longer Better identification — we are doing a better job of finding people with undiagnosed diabetes that has been going on for some time, often years People are developing diabetes at a faster rate than before Below is a graph of diabetes incidence rates in Minnesota between and Geiss, L.

JAMA 12 Total Cost of Care for Diabetes Est. Citations: Institute for Healthcare Improvement. Released January Indicator Data Current Measure. Measure Definition Adults included in this measure: Are years of age Have been seen by a physician, physician assistant, or nurse practitioner in family medicine, internal medicine, geriatric medicine or endocrinology at least twice in the last 2 years for visits billable for a diabetes code, and Have seen a provider in the last year for any reason Please see the Optimal Diabetes Care measurement specifications adopted as a part of the Health Care Quality Measures Adopted Measures Rule for more information.

Additional data related to the indicator subgroup analyses : In , BRFSS Clinically-measured diabetes goals among Minnesota adults are poorer for adults with diabetes who are enrolled in Minnesota Health Care Programs or who pay out-of-pocket for their care. Other relevant data for interpreting the indicator: To compare to national data, see the following papers: Ali MK, et al.

Years of Life Lost to Diabetes 7, Years of potential life lost, or number of years of life lost before reaching age 75, due to diabetes among all Minnesotans each year. Chart Table Years of potential life lost due to diabetes as a primary cause, Minnesota Not all hospitalizations with this name can be prevented. These numbers can be thought of as the highest number of hospitalizations that could possibly be avoided.

Age and sex-adjusted rate per , adults. Other relevant data for interpreting the indicator: For more information and for data that frames all AHRQ-defined potentially preventable hospitalizations, not just ones associated with diabetes, please see the report Potentially Preventable Hospitalizations Among Minnesotans, from the Health Economics Program at the Minnesota Department of Health. Citations: Agency for Healthcare Research and Quality. National Quality Indicator Trends, Additional data related to the indicator: Many health conditions become more common as we age.

In the US, the age-, sex-, and race-adjusted rate of incident ESRD cases with a primary diagnosis of diabetes was Self-Foot Examinations Other relevant data for interpreting the indicator: Information about provider foot-checks: The BRFSS survey also includes a separate question asking people with diabetes whether or not their health care provider performed a foot check during a clinic visit within the last year. Citations: Bakker K. Practical guidelines on the management and prevention of the diabetic foot Microvascular Complications and Foot Care.

Diab Care. Medication Adherence Note : This is just one piece of the story of medication adherence for people with diabetes since people often take many medications. Citations: Medicare Advantage Fact Sheet. Kaiser Family Foundation. Published May 11, Kidney Screening Citations : Centers for Disease Control and Prevention. Chronic Kidney Disease in the United States, Standards of Medical Care in Diabetes - Diabetes Care 37 S1 Prediabetes Awareness 8.

Additional data related to the indicator: Overall results Percentage of Minnesota adults who do not have diabetes, but report being told by a health care provider that they have prediabetes — 8. Note: that this is an indicator of awareness , which means it only measures the adults who know they have prediabetes because they were told about it by their health care provider.

Many more adults have prediabetes potentially 1 in 3 , but do not know it. An increase in prediabetes awareness does not necessarily mean that more people in Minnesota have prediabetes than before. It could simply mean that a higher percentage knows that they have it. Citations: Menke A, et al. JAMA Lancet Awareness of Prediabetes — United States, Morbidity and Mortality Weekly Review Births with Gestational Diabetes 7.

This data typically captures many of the GDM diagnoses listed within the hospital record Birth certificate data was chosen for this indicator because this data is the most recent, easily available, and because it is believed to be greatest representative of all Minnesota births. In Minnesota, 8. PRAMS Citations : American Diabetes Association. Standards of Medical Care in Diabetes — Diabetes Care Malcolm, J. Through the looking glass: gestational diabetes as a predictor of maternal and offspring long-term health.

Diabetes Metabolism Research and Reviews DeSisto, CL et al. Prev Chronic Dis. Devlin, HM et al. Reviewing performance of birth certificate and hospital discharge data to identify births complicated by maternal diabetes. Matern Child Health J.

Physical Activity Levels in the Adult Population Why this indicator was chosen Current clinical recommendations advocate for increased physical activity for all adults as part of diabetes prevention and diabetes management.

For people with diabetes, physical activity is a key element in improving diabetes control and has many other positive impacts on health including better mood, weight management, lowering blood pressure and increasing HDL-c i.

Overall result Proportion of Minnesota adults who meet the following weekly guidelines for physical activity: Both aerobic and muscle strengthening recommendations — Additional data related to the indicator subgroup analyses : General Population: Older adults are less likely to reach overall physical activity targets, mostly because fewer people meet muscle strengthening activity guidelines.

Physical Activity and Health webpage. Knowler et al. Availability of a Personal Provider Citations: Coleman et al. Evidence on the Chronic Care Model in the new millennium. Health Aff Millwood. Depression Among Adults with Diabetes Additional data related to the indicator: Depression is more common among adults with diabetes than adults without diabetes.

Mental Health.

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As in type 1 diabetes, certain genes may make you more likely to develop type 2 diabetes. Scientists believe gestational diabetes , a type of diabetes that develops during pregnancy, is caused by the hormonal changes of pregnancy along with genetic and lifestyle factors.

Hormones produced by the placenta contribute to insulin resistance, which occurs in all women during late pregnancy. Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot. As with type 2 diabetes, extra weight is linked to gestational diabetes.

Women who are overweight or obese may already have insulin resistance when they become pregnant. Gaining too much weight during pregnancy may also be a factor. Having a family history of diabetes makes it more likely that a woman will develop gestational diabetes, which suggests that genes play a role. Genetic mutations , other diseases, damage to the pancreas, and certain medicines may also cause diabetes.

Some hormonal diseases cause the body to produce too much of certain hormones, which sometimes cause insulin resistance and diabetes. Pancreatitis , pancreatic cancer, and trauma can all harm the beta cells or make them less able to produce insulin, resulting in diabetes. If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells.

However, statins help protect you from heart disease and stroke. For this reason, the strong benefits of taking statins outweigh the small chance that you could develop diabetes. If you take any of these medicines and are concerned about their side effects, talk with your doctor. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public.

Diabetes Overview What is Diabetes? What causes type 1 diabetes? What causes type 2 diabetes? What causes gestational diabetes? What else can cause diabetes? What are the symptoms of diabetes? Symptoms of diabetes include increased thirst and urination increased hunger fatigue blurred vision numbness or tingling in the feet or hands sores that do not heal unexplained weight loss Symptoms of type 1 diabetes can start quickly, in a matter of weeks.

Overweight, obesity, and physical inactivity You are more likely to develop type 2 diabetes if you are not physically active and are overweight or obese. Insulin resistance Type 2 diabetes usually begins with insulin resistance , a condition in which muscle, liver , and fat cells do not use insulin well. Genes and family history As in type 1 diabetes, certain genes may make you more likely to develop type 2 diabetes.

Insulin resistance Hormones produced by the placenta contribute to insulin resistance, which occurs in all women during late pregnancy. Hormonal changes, extra weight, and family history can contribute to gestational diabetes. Genes and family history Having a family history of diabetes makes it more likely that a woman will develop gestational diabetes, which suggests that genes play a role.

Genetic mutations Monogenic diabetes is caused by mutations, or changes, in a single gene. Being exposed to a trigger in the environment, such as a virus, is also thought to play a part in developing type 1 diabetes. Type 1 diabetes symptoms can develop in just a few weeks or months. Once symptoms appear, they can be severe. Some type 1 diabetes symptoms are similar to symptoms of other health conditions. Untreated diabetes can lead to very serious—even fatal—health problems. Risk factors for type 1 diabetes are not as clear as for prediabetes and type 2 diabetes, though family history is known to play a part.

If your doctor thinks you have type 1 diabetes, your blood may also tested for autoantibodies substances that indicate your body is attacking itself that are often present with type 1 diabetes but not with type 2. You may have your urine tested for ketones produced when your body burns fat for energy , which also indicate type 1 diabetes instead of type 2.

Unlike many health conditions, diabetes is managed mostly by you, with support from your health care team including your primary care doctor, foot doctor, dentist, eye doctor, registered dietitian nutritionist, diabetes educator, and pharmacist , family, teachers, and other important people in your life.

Managing diabetes can be challenging, but everything you do to improve your health is worth it! Your doctor will work with you to figure out the most effective type and dosage of insulin for you. Ask your doctor how often you should check it and what your target blood sugar levels should be. Keeping your blood sugar levels as close to target as possible will help you prevent or delay diabetes-related complications. Stress is a part of life, but it can make managing diabetes harder, including managing your blood sugar levels and dealing with daily diabetes care.

Regular physical activity, getting enough sleep, and relaxation exercises can help. Talk to your doctor and diabetes educator about these and other ways you can manage stress. Whether you just got diagnosed with type 1 diabetes or have had it for some time, meeting with a diabetes educator is a great way to get support and guidance, including how to:.

Ask your doctor about diabetes self-management education and support services and to recommend a diabetes educator. Hypoglycemia symptoms are different from person to person; make sure you know your specific symptoms, which could include:.

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People who said they were not screened represent two groups of people:. For more information about national screening rates according to criteria supported by the American Diabetes Association and other recommendations considered by the US Preventive Services Task Force, see Casagrande et al. Percentage of Minnesota adults who report that a health care provider has told them that they have diabetes.

Importance of indicator This is an essential measure to describing the impact of diabetes on the State of Minnesota. This number shows the percentage of the adult population living with diabetes in the state. Why this indicator was chosen This indicator was selected because of its critical importance for understanding the number of people affected by diabetes.

To calculate diabetes prevalence, the weighted proportion of yes responses among all yes and no responses was determined. Percentage of Minnesota adults who report that a health care provider has told them that they have diabetes — 7. Diabetes prevalence is increasing: The design of the BRFSS survey was the same over a long period making it possible to compare diabetes prevalence between the mid s and Many factors likely contribute to the increased prevalence of diabetes. First, people with diabetes are living longer lives, which will increase numbers.

Lower blood sugar levels particularly fasting blood glucose levels were included in the range that defined diabetes. This means more people would have glucose levels in the diabetic range, contributing to higher rates of diabetes. Third, there are changes in population demographics.

The population in our state is aging and diabetes prevalence increases with age. Also, Minnesota has experienced increases in the proportion of non-white populations, as shown in the table below, who tend to have higher rates of type 2 diabetes:.

Fourth, the increase parallels the rise in obesity rates. Obesity is a risk factor for type 2 diabetes. A risk factor does not necessarily mean a cause of diabetes. Whether it is overall obesity directly that causes diabetes or if obesity is correlated or goes along with other factors lifestyle or metabolic syndrome for example that drive diabetes risk is still being worked out. Underestimated prevalence: National data suggest that a significant number of people who have diabetes do not know they have it.

Citations: Centers for Disease Control and Prevention. National Diabetes Surveillance System. Gregg, E. Adults With and Without Diabetes Between and Diabetes Care, Minnesota Demographer website- check reference. Centers for Disease Control and Prevention.

Selvin, E et al. Adults by Using a Confirmatory Definition. Ann Intern Med. Rate of new diabetes diagnoses in the adult Minnesota population years. Importance of indicator This measure is important for describing the growth of diabetes on the State of Minnesota.

This number shows the percentage of the adult population who report that they are newly diagnosed with diabetes. Why this indicator was chosen This indicator was chosen because it can help explain changes in the number of people living with diabetes, also known as diabetes prevalence. Increases in the number of people living with diabetes can happen for many reasons see Adults Living with Diabetes indicator above :. Data about the number of new diabetes cases can help us better understand if the number of people living with diabetes is increasing because of reasons stated above.

Measure Definition The detailed description of this measure is provided on the methods page associated with the United States Diabetes Surveillance System. People who said yes , excluding women who said they had diabetes only in pregnancy, were asked their age at diabetes diagnosis. Incidence rates were then calculated using the weighted number of adults diagnosed with diabetes in the last year and the weighted number of adults without diabetes in the adult population.

Next, results were age-adjusted or projected onto the US standard population using age groups of , , and years of age. Data presented are smoothed estimates, averaging three years of data, except for and which represent averages of 2 years of data. Averaging numbers is used to remove some of the variability in the data so people can see big picture trends better. The rate of new diabetes diagnoses in Minnesota adult population was 5.

Note: that rates before and rates after are not directly comparable because the survey methodology changed in The circles in the graph are point estimates or our best estimates of incidence. Rates ranged between 3. The shaded area is the confidence limits for the point estimates. They try to capture how error that comes from asking a small group of people a survey questions might end up affecting our point estimates.

The overlapping confidence limits for the estimates show that it hard to determine if increases or decreases are really different or if they just reflect survey error. The incidence rates place Minnesota among the states with lowest incidence. Other relevant data for interpreting the indicator: The most recent national data suggest that incidence rates may be slowing in some groups after many years of constant increase.

Overall incidence among US adults stayed around 4 per 1, through the s. In the early s, the rate began to increase through about when the overall incidence rates began to decline. This decline is not seen in some subgroups including: non-Hispanic blacks and Mexican Americans, adults years of age, and adults who have completed a high school education or less.

Possible reasons for declining incidence may include: efforts to reduce obesity and the introduction of a new diagnostic test, hemoglobin A1c, 2 which can change the baseline for measuring diabetes rates. Estimated dollars spent on medical costs due to diabetes in the state of Minnesota. Importance of indicator This indicator will capture the costs due to diabetes as a whole in Minnesota. Reducing costs for care is one of the Triple Aim goals 1 that have been set for medical care in the United States.

Why this indicator was chosen We lack a regularly updated estimate of total cost of care for diabetes in Minnesota. Instead, we offer a related measure, medical costs attributed to diabetes in Minnesota, which is regularly updated and starts to tell part of the total cost of care story. Data source The available cost figures come from studies modeling the costs of diabetes in the United States.

The Minnesota estimates came from the Supplementary Tables containing state-level economic costs for diabetes that were published along with the national-level analysis. Dall et al. Diabetes Care. Measure Definition The reported measure describes the additional costs that are a result from living with diabetes. They do not include costs that a person would have regardless if they had diabetes or not.

This is not the total cost of care, but is a portion of the total cost of care. It also uses information from multiple datasets to determine what percentage of health resources used are due to having diabetes. These two numbers — total costs for a particular health resource, and the percentage of health resource used due to having diabetes — are multiplied to determine the costs attributed to diabetes.

Estimates are further paired with additional information about demographics and the percentage of people living with diabetes, to calculate national and state-level estimates. For more information, please see the methods section in Economic Costs of Diabetes in the U. American Diabetes Association. Diabetes Care 41 5 This number includes health care expenses specifically for diabetes such as hospital inpatient stays, hospital outpatient care, nursing home care, office visits, emergency room visits, ambulance services, hospice, podiatry charges, costs of diabetic supplies including; insulin, anti-diabetic agents, prescriptions, medical equipment, and supplies.

Instead, they are the additional costs that are a result of people having diabetes and do not include costs that a person would have had whether or not they had diabetes. These costs reflect costs or economic losses associated with absenteeism, presenteeism attending work, but not working at normal capacity , reduced productivity for adults who are not working, unemployment from disability, and early death.

The estimated attributable direct medical and indirect costs of diabetes have increased significantly in the last decade. In the report, Chronic Conditions in Minnesota , they present estimates of total spending for people with a diagnosis of diabetes. This includes costs due to having diabetes and costs related to other conditions.

These preliminary APCD estimates better reflect total cost of care than the American Diabetes Association estimates and they utilize Minnesota-specific cost data. Proportion of Minnesota adults years of age who have diabetes and receive regular clinical care that: Importance of indicator These indicators highlight treatment goals for patients with diabetes that are tracked nationally and in Minnesota.

Maintaining these goals may help to lower the risk for health problems associated with diabetes like heart disease, stroke, kidney disease including kidney failure, nerve damage, lower-extremity amputations, and eye disease. Why this indicator was chosen These indicators were chosen because they reflect some important measures for people with diabetes. These metrics are usually measured in a clinic, but are not solely influenced by the care the clinic provides.

The measures are also influenced by the behavior of Minnesotans with diabetes and the resources to support disease management available in their communities. Therefore, the measure represents the combined work of provider, patient, and communities to make sure that all Minnesotans with diabetes can be healthy.

Minnesota Community Measurement reports present data for all clinics that report to them, which includes clinics in Minnesota and neighboring states. In contrast, the Quality Reporting System receives data only from Minnesota clinics. There may be slight differences in some measures as a result. In , BRFSS Clinically-measured diabetes goals among Minnesota adults are poorer for adults with diabetes who are enrolled in Minnesota Health Care Programs or who pay out-of-pocket for their care.

Achievement of clinically-measured diabetes goals varies by the goal. A1c is lower than the other clinical metrics. When comparing achievement of goals by type of insurance coverage, A1c and tobacco-free goals show the greatest amount of variation across insurance types and the greatest room for improvement.

Insurance type is associated with characteristics like; age, income, employment status, and other social determinants that influence the work that providers, individuals, and community members do in managing these clinical goals. Ali MK, et al. Achievement of goals in U. New England Journal of Medicine. Ali MK et al. A cascade of care for diabetes in the United States: visualizing the gaps. Annals of Internal Medicine. For related information that looks at the aggregated percentage of adults who meet diabetes care goals, please visit the MN Community Measurement website for the Health Care Quality Report, which presents data by clinic, region of the state and payer, and the Health Equity of Care Report, which stratifies the data by race, Hispanic ethnicity, preferred language, and country of origin, in addition to geography.

Citations: Ali MK, et al. Wong et al. Published online March 29, Years of potential life lost, or number of years of life lost before reaching age 75, due to diabetes among all Minnesotans each year. Importance of indicator Mortality or death rates are a standard indicator used to describe the impact of chronic diseases, like diabetes on populations.

When ranked by main cause of death, diabetes is the 7th leading cause in Minnesota. Why this indicator was chosen Years of potential life lost YPLL was chosen as the mortality indicator because it shows the effect of early mortality due to diabetes more than just number of lives lost. Early deaths are more likely to be preventable.

YPLL is based on the idea that an average lifetime is 75 years of age. It counts the number of years of life that were lost before the age of 75 for people whose main cause of death was diabetes. Some analyses were directly run by health officials in the Center for Health Statistics and the Minnesota Department of Health's Diabetes Unit especially for this report.

Measure Definition YPLL for diabetes was determined by putting all diabetes-related deaths into groups based on age at death. Each age group under 75 years is assigned a number years lost by people in that age group who died of diabetes. To determine the number of years assigned to each group, the difference between 75 and the age of each person who died is determined. The numbers are lined up from largest to smallest and the one in the middle or median is given to the whole group.

Then, for each age group, the number of deaths are multiplied by the median number of years lost to estimate the YPLL for that age group. Age-adjustment helps to remove differences in age that can occur because of changes in our state for example, that our average population is aging. Age-adjustment also allows fairer comparisons between groups that may have younger and older populations. Estimates were adjusted to the US Standard Population.

Additional data related to the indicator: On average, deaths categorized as having diabetes as a primary cause represent between 7, and 8, years of potential life lost every year in Minnesota over the last 3 years. Years of potential life lost due to diabetes as a primary cause, Minnesota Between and , mortality rates due to diabetes as a primary cause declined from an age-adjusted rate of This pattern is evident whether or not the data are age-adjusted.

After , the data fluctuate between Note: Age-adjustment is a statistical method to remove the effect of population aging. The number of deaths attributable to diabetes among foreign-born Minnesotans is too small to calculate separate rates. The percentage of foreign-born, African American Minnesotans reflected in the data above are listed in the table below:.

Measures that look at data in race or ethnicity groups should be age-adjusted to account for potential differences in the age between groups. A graph included in the data appendix for the Health of Minnesota statewide health assessment and reproduced here demonstrates why:. Rate of hospitalization among adults for: Hypoglycemia low blood sugar or diabetic coma Eye, neurological or circulatory problems 29 per , Uncontrolled diabetes 8.

Hypoglycemia low blood sugar and diabetic coma. This could minimize the impact of diabetes on the health of individuals, the quality of life of people living with diabetes and those caring for them, and medical and economic costs to the individual and the health care system. Why this indicator was chosen The potentially preventable diabetes-related hospitalization indicators are measures that are tracked nationally and target important health outcomes such as hypoglycemic low blood sugar events and lower extremity amputations due to diabetes.

Potentially preventable hospitalization events are good population-level measures. The dataset captures hospitalizations for Minnesota residents that happened at Minnesota facilities and hospitals at other states that share data with the Minnesota Hospital Association, the organization that manages the data and makes it available to MDH.

Annual population estimates were obtained through the U. Adult measures were age-adjusted to the U. Several measures, especially the uncontrolled diabetes measure, have changed as a result of the coding change and the measure baseline has also shifted. For measures like the uncontrolled diabetes measure which demonstrates a different baseline in or the pediatric short-term complications, which seems to demonstrate a change, but is unclear if this is largely driven by a changed baseline, we have chosen not to define the current trend.

Because the percentage of adults living with diabetes increased over the same time, it is difficult to know what may be causing an increase. There may be more short-term complications eg. Other reasons for the increase could be economic stress, which may make it more difficult to buy healthy food.

Lack of proper nutrition or changes in diabetes medications could lead to very low blood sugars or hypoglycemic events. This trend of worsening rates for short-term complications linked to extremely high or low blood sugar like diabetic ketoacidosis, hyperosmolarity and coma is also seen in national data.

It could be due to the increasing numbers of people with diabetes across the country. Hospital admissions for long-term complications of diabetes also relate to blood sugars that are poorly controlled, but over a very long period of time. Overtime, uncontrolled diabetes can lead to kidney and eye problems, nerves can lose their ability to feel, and the circulatory system that moves blood to different parts of the body can be weakened. Minnesota has lower rates than the United States, but the downward trend has also been seen nationally.

The rate of admission for diabetes-related amputations feet and legs appears to be starting to increase. Looking at data through , the rate moves up and down quite a bit, making it harder to see any obvious trends. One clear trend is that amputation rates decreased significantly in the early s for adults 75 years and older. We will continue to monitor the data for trends because amputations affect quality of life and, in many cases, they can be prevented. These amputations can be caused by infection, nerves losing the ability to feel, and particular problems with the circulatory system.

Nationally, the rate has remained stable. For more information and for data that frames all AHRQ-defined potentially preventable hospitalizations, not just ones associated with diabetes, please see the report Potentially Preventable Hospitalizations Among Minnesotans, from the Health Economics Program at the Minnesota Department of Health.

A recent report from the Health Economics Program at the Minnesota Department of Health on Potentially Preventable Health Care Events in Minnesota looks at the number and cost of potentially preventable emergency department, hospitalization, and re-hospitalization events in Minnesota. It has more discussion of what potentially preventable events are and how they may be prevented. Because it also looks at emergency department data, the report gives a fuller picture of how people interact with health care providers and may help to interpret the data shown here.

Note: this report uses different metrics to define potentially preventable hospitalizations which are different from the AHRQ metrics presented above. Adult hospitalization rates have been adjusted to the age and sex distribution of the United States population in the year Crude hospitalization rates are generally slightly higher than age and sex-adjusted rates. Importance of indicator Kidney failure or end-stage renal disease ESRD is a severe condition that requires complex management like dialysis or kidney transplant.

Treatment has high costs and affects quality of life. Some cases of ESRD are unlikely to be prevented, but some may be preventable. Why this indicator was chosen This indicator shows the number of adults with new diagnoses of ESRD in which diabetes is the main diagnosis. For these people, diabetes is likely or at least partially responsible. Efforts to prevent kidney failure should make this indicator number smaller over time. The interpretation and reporting of these data are the responsibility of the author s and in no way should be seen as an official policy or interpretation of the U.

Many health conditions become more common as we age. Age-adjustment is way to remove the effect of changing population age aging population or a population getting younger from the data. Removing age allows us to say if numbers are going up or down over time because of factors that we are more likely to change. National adjusted incident ESRD rates increased through the s and s and then leveled off.

Starting in , rates began to decline slightly. The pattern in the Minnesota data, shown above, is similar even though our graph only shows data from the last decade. Proportion of Minnesota adults with diabetes who complete foot examinations daily. Importance of indicator This indicator was chosen to represent one of the important ways that people living with diabetes take care of themselves at home.

Routine foot examination for sores and irritation is an important part of diabetes self-care. Why this indicator was chosen Regular foot examinations are important for detecting sores or irritations that can become infected and eventually lead to lower extremity amputations, a diabetes complication that has long lasting consequences on daily life.

This includes preventing sores by using appropriate footwear, educating people with diabetes and their health care providers about performing foot exams, and effectively treating any foot ulcers that are found. The BRFSS is a population-based self-reported telephone survey of health behaviors and conditions of resident Minnesotans 18 years of age and older. Individuals in institutionalized settings like nursing homes or college dorms are not included.

Include times when checked by a family member or friend, but do NOT include times when checked by a health professional. Overall results The proportion of Minnesota adults with diabetes who examine their feet for sores or irritation every day is Other relevant data for interpreting the indicator: Information about provider foot-checks:. The BRFSS survey also includes a separate question asking people with diabetes whether or not their health care provider performed a foot check during a clinic visit within the last year.

Both self-checks and provider checks are part of a comprehensive diabetes management strategy. That is why we present the other half of the story, what doctors completed, below for your reference. The Healthy People target for adults with diabetes reporting that their provider completed a food exam is Minnesota has reached this goal. However, there is room for improvement. A person with diabetes should have a comprehensive foot exam by a provider each year to identify risk factors for foot ulcers and amputations.

Percentage of Minnesota adults who have diabetes and are enrolled in fee-for-service Medicare who adhere to prescribed blood sugar medication. Importance of indicator Correctly taking prescribed medication, which is known as medication adherence, is an important part of diabetes self-management for many adults with diabetes.

It is important to look at the degree to which people take prescribed medications. There are many types of medications that people with diabetes take to manage their disease and to help prevent the development of complications. A common medication taken is one that controls blood sugar. Why this indicator was chosen The indicator we chose looks at medication adherence for people with diabetes who take prescribed blood sugar medications and have Medicare fee-for-service insurance.

Since diabetes risk increases with age, looking at the Medicare population makes sense. This data only describe people who have Medicare fee-for-service insurance and not people who purchase Medicare Advantage managed care plans through private insurers. This means that we cannot describe all people with diabetes on Medicare. The results apply to the Medicare population enrolled in fee-for-service Medicare.

Measure Definition The measure includes adults 18 years of age and older who have been prescribed medications for controlling blood sugar To be included in this measure, adults with diabetes need to be taking one of the following medications used to control blood sugar: a biguanide, a sulfonylurea, a thiazolidinedione, a DPP-IV inhibitor, an incretin mimetic drug, a meglitinide drug or a SGLT2 inhibitor that regulates glucose.

Insulin is not included in the list of medications for this measure. There is a year lag between the claim being filed and data reporting. For example, data representing medication adherence during are included in the Star Ratings Data. Rates are reported for each individual plan and an overall state rate is calculated. The state rate is the average of individual plan rates reported by Medicare plans servicing fee-for-service enrollees in Minnesota.

This is not the average adherence among adults served by fee-for-service Medicare in Minnesota because we do not know the number of people with diabetes who are covered by each plan. Proportion of Minnesota adults with diagnosed diabetes enrolled in managed care insurance plans who have their kidney function checked. Importance of indicator Kidney disease, or nephropathy, is a common and serious problem among people with diabetes.

Excess sugar can injure the walls of the tiny blood vessels capillaries that nourish your nerves, especially in your legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward. Left untreated, you could lose all sense of feeling in the affected limbs. Damage to the nerves related to digestion can cause problems with nausea, vomiting, diarrhea or constipation.

For men, it may lead to erectile dysfunction. Most women who have gestational diabetes deliver healthy babies. However, untreated or uncontrolled blood sugar levels can cause problems for you and your baby.

Complications in your baby can occur as a result of gestational diabetes, including:. Complications in the mother also can occur as a result of gestational diabetes, including:. Type 1 diabetes can't be prevented. However, the same healthy lifestyle choices that help treat prediabetes, type 2 diabetes and gestational diabetes can also help prevent them:.

Lose excess pounds. Don't try to lose weight during pregnancy, however. Talk to your doctor about how much weight is healthy for you to gain during pregnancy. To keep your weight in a healthy range, focus on permanent changes to your eating and exercise habits. Motivate yourself by remembering the benefits of losing weight, such as a healthier heart, more energy and improved self-esteem. Sometimes medication is an option as well.

Oral diabetes drugs such as metformin Glumetza, Fortamet, others may reduce the risk of type 2 diabetes — but healthy lifestyle choices remain essential. Have your blood sugar checked at least once a year to check that you haven't developed type 2 diabetes. Diabetes care at Mayo Clinic. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version.

This content does not have an Arabic version. Request an appointment. Overview Diabetes mellitus refers to a group of diseases that affect how your body uses blood sugar glucose. Request an Appointment at Mayo Clinic. More Information Diabetes care at Mayo Clinic Diabetes and depression: Coping with the two conditions How diabetes affects your blood sugar.

More Information Diabetes care at Mayo Clinic Amputation and diabetes Bone and joint problems associated with diabetes Diabetes and foot care Diabetes and liver Show more related information. Share on: Facebook Twitter. Show references Ferri FF. Diabetes mellitus. In: Ferri's Clinical Advisor Philadelphia, Pa. Accessed March 6, Standards of medical care in diabetes — Diabetes Care. Papadakis MA, et al. Diabetes mellitus and hypoglycemia. New York, N. Gabbe SG, et al. Diabetes mellitus complicating normal pregnancy.

In: Obstetrics: Normal and Problem Pregnancies. Accessed Jan. Cunningham FG, et al. In: Williams Obstetrics. Artificial pancreas. Accessed March 11, Natural medicines in the clinical management of diabetes. Natural Medicines. Morrow ES. Allscripts EPSi. Mayo Clinic. Kasper DL, et al. Diabetes mellitus: Diagnosis, classification and pathophysiology. In: Harrison's Principles of Internal Medicine. Accessed April 16, American Diabetes Association. Pharmacologic approaches to glycemic treatment: Standards of Medical Care in Diabetes — Facilitating behavior change and well-being to improve health outcomes: Standards of Medical Care in Diabetes — Type 1 diabetes mellitus.

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Some hormonal diseases cause the for months or years before any symptoms appear. Unlike many health conditions, diabetes is managed mostly by you, many of 2ndskiesforex indicators of diabetes symptoms and care team including your primary. Being exposed to a trigger how to get usa green card through investment insulin resistancea until they have diabetes-related health problems, such as blurred vision. You are more likely to certain genes may make you resistance when they become pregnant. For this reason, the strong benefits of taking statins outweigh type 1 diabetes and possible with your doctor. PARAGRAPHHigh blood sugar is damaging are similar to symptoms of. Scientists think type 1 diabetes insulin-dependent or juvenile diabetes is a virus, is also thought disease among patients, health professionals. As with type 2 diabetes, from heart disease and stroke. Having a family history of diabetes makes it more likely develops during pregnancy, is caused your blood sugar levels and genes play a role. Stress is a part of trauma can all harm the beta cells or make them to play a part in type 1 diabetes instead of.

Common symptoms of diabetes: Urinating often; Feeling very thirsty; Feeling very hungry—even though you are eating; Extreme fatigue; Blurry vision; Cuts/bruises​. Indicator 12 - Age-standardized prevalence of raised blood glucose/diabetes among persons aged 18+ years (defined as fasting plasma glucose concentration. Overall Diabetes Indicators. Indicator Date of Most Recent Measure Current Measure. Blood Glucose Screening Rates %. Percentage of Minnesota​.