D-11 Increase the proportion of adults with diabetes who have a glycosylated hemoglobin measurement at least twice a year

National Data Source
Behavioral Risk Factor Surveillance System (BRFSS); Centers for Disease Control and Prevention, Public Health Surveillance and Informatics Program Office (CDC/PHSIPO)
Changed Since the Healthy People 2020 Launch
percent (age adjusted—see Comments)
Baseline (Year)
64.6 (2008)
Target-Setting Method
10 percent improvement
Number of persons aged 18 years and older who report they have ever been diagnosed with diabetes and report that a doctor, nurse, or other health professional has checked the respondent’s glycosylated hemoglobin (HbA1c) two or more times in the past year
Number of persons aged 18 years and older who report they have ever been diagnosed with diabetes
Questions Used to Obtain the National Baseline Data

From the 2008 Behavioral Risk Factor Surveillance System:


A test for "A one C" measures the average level of blood sugar over the past three months. About how many times in the past 12 months has a doctor, nurse, or other health professional checked you for "A one C"?

Variable Name: CHKHEMO3

  • _ _ Number of times [76=76 or more]
  • (88) None
  • (98) Never heard of "A one C" test
  • (77) DK/Ns
  • (99) Refused


Have you ever been told by a doctor that you have diabetes? (If "Yes" and respondent is female, ask "Was this only when you were pregnant?")

Variable Name: DIABETE2

  • (1) Yes
  • (2) Yes, but female told only during pregnancy
  • (3) No
  • (4) No, pre-diabetes or borderline diabetes
  • (7) DK/Ns
  • (9) Refused
Data Collection Frequency
Comparable Healthy People 2010 Objective
Retained from HP2010 objective


Methodology Notes

Persons are considered to have diabetes if they have ever been told by a doctor or health professional that they have diabetes or sugar diabetes. Women who report that the only time they have been diagnosed with diabetes was during pregnancy (gestational diabetes) are excluded. Persons who report that they have pre-diabetes or borderline diabetes are also excluded from the measure. Persons are considered to have been measured for glycosylated hemoglobin if they have been checked for HbA1c two or more times in the past 12 months.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 18-44, 45-64, 65+
  • Sex: 18-44, 45-64, 65+
  • Race/Ethnicity: 18-44, 45-64, 65+
  • Educational Attainment: 25-44, 45-64, 65+
  • Household Income: 18-44, 45-64, 65+
  • Disability Status: 18-44, 45-64, 65+
  • Geographic Location: 18-44, 45-64, 65+
  • Health Insurance Status: 18-44, 45-64
  • Marital Status: 18-44, 45-64, 65+
  • Obesity Status: 18-44, 45-64, 65+
Caveats and Limitations
Persons who reported that they have never heard of an HbA1c test are counted as not having had the test. It is possible that some of these people have had an HbA1c test and reported that they do not know due to either communication or cognitive difficulties. The BRFSS is conducted independently by each state and therefore methodologies may vary. Pooled national estimates may not take into account these differences and so may differ from estimates obtained using data sources that use methodologies designed to produce national estimates.
Trend Issues
Data for this objective are collected using the core component and an optional module of the BRFSS, which is made available to States for administration annually. The number of States that select the diabetes module varies every year. In 2008, 38 States used the optional diabetes module. The measure is the mean of data for the reporting States.