Monitoring of key biomedical targets aims to reduce and manage diabetes complications. Two key monitoring targets are:
- keep blood glucose levels within a specified target range
- maintain blood pressure within acceptable levels.
Blood glucose monitoring helps health professionals determine the best management strategy for people living with diabetes. Keeping blood glucose levels within a target range can help reduce a person’s risk of developing a range of diabetes-related complications.
HbA1c testing rates
According to the NPS MedicineInsight General practice insights report (NPS MedicineWise, 2021), in 2019–20, more than two-thirds (67%) of general practice patients with a diagnosis of diabetes (20 years and older) had at least one test result for HbA1c levels. More than half of these patients (52%) had at least one result that was ≥ 53 mmol/mol.
Amongst MedicineInsight patients without a diagnosis of diabetes, only 11% had received at least one test for HbA1c levels. Around 3% of the general practice patients tested without diabetes had a result ≥ 48 mmol/mmol (0.3% of all patients with no recorded diagnosis of diabetes).
The Australian National Diabetes Audit – Australian Quality Clinical Audit (ANDA – AQCA) provides biennial updates on diabetes practice processes and outcome data for participating diabetes services across all states and territories in Australia (Department of Health 2021). Among all adult patients with diagnosed diabetes recording a blood glucose result (n=4,262), the median HbA1c level was 63.0 mmol/mol. Median HbA1c was slightly higher among patients with type 1 diabetes (66.0 mmol/mol) and slightly lower in patients with type 2 diabetes (62.0 mmol/mol). Patients with gestational diabetes recording a blood glucose result (n = 49) had significantly lower median HbA1c levels (34.0 mmol/mol).
Diabetes with an HbA1c result
The Practice Incentives Program (PIP) Quality Improvement Measures (QI) Quality Improvement Measure 1 (QIM 1) reports on the proportion of regular clients with a recorded diagnosis of type 1, type 2 or undefined diabetes and who had a HbA1c result in their GP record from the previous 12 months. Regular clients are defined as individuals who had visited a practice 3 or more times in the previous 2 years and data are collected from over 5,700 general practices across Australia (AIHW 2021).
As of July 2021, 59% of regular clients with a record of type 1 diabetes had an HbA1c result recorded in their GP record in the previous 12 months. This proportion was higher in regular clients with a record of type 2 diabetes (73%) and undefined diabetes (66%). The proportion of regular clients with an HbA1c result in the previous 12 months increased with increasing age and was highest in the 65 and over age group for type 1, type 2 and undefined diabetes.
Diabetes with blood pressure recorded
The PIP QI Quality Improvement Measure 10 (QIM 10) provides information on the proportion of regular clients with a diagnosis of diabetes (type 1, type 2 or undefined) and a recorded blood pressure in their GP record in the previous 6 months (AIHW 2021).
As of July 2021, 59% of regular clients with diabetes had blood pressure recorded in their GP record in the previous 6 months. This proportion was 7% higher than in October 2020 (52%) and increased with increasing age. It was highest in the 65 and over age group (64% in males and 64% in females) and lowest in the 0-14 age group (6% in males and 8% in females).