D-5.1 Reduce the proportion of persons with diabetes with an A1c value greater than 9 percent

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent (age adjusted—see Comments)
Baseline (Year)
17.9 (2005-2008)
Target
16.1
Target-Setting Method
10 percent improvement
Numerator
Number of adults aged 18 years and older with doctor diagnosed diabetes and with HbA1c values >9%
Denominator
Number of adults aged 18 years and older who report that they have ever been diagnosed with diabetes
Questions Used to Obtain the National Baseline Data

From the 2005-2008 National Health and Nutrition Examination Survey:

[NUMERATOR:]

{Other than during pregnancy, {have you/has SP}/{Have you/Has SP}} ever been told by a doctor or other health professional that {you have/{he/she/SP} has} diabetes or sugar diabetes?

  • (1) Yes
  • (2) No
  • (3) Borderline
  • (7) Refused
  • (9) Don't know
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Leading Health Indicator
Clinical Preventive Services

Comments

Methodology Notes

Persons are considered to have diagnosed diabetes(denominator) if they respond ‘yes’ to the question. Those who respond borderline are counted as ‘no’. Women who report that the only time they have been diagnosed with diabetes was during pregnancy (gestational diabetes) are also excluded.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Educational Attainment: 25-49, 50-59, 60-69, 70-79, 80+
  • Race/Ethnicity: 18-49, 50-59, 60-69, 70-79, 80+
  • Family Income: 18-49, 50-59, 60-69, 70-79, 80+
  • Sex: 18-49, 50-59, 60-69, 70-79, 80+
  • Health Insurance Status: 18-49, 50-59, 60-64
  • Obesity Status: 20-49, 50-59, 60-69, 70-79, 80+
  • Veteran Status: 18-49, 50-59, 60-69, 70-79, 80+
  • Total: 18-49, 50-59, 60-69, 70-79, 80+
Trend Issues
Hemoglobin A1c results for 2007-2008 (GHB_E) and 2009-2010 (GHB_F) were temporarily withdrawn in November 2011 to evaluate a shift to the right (increased values) in the distribution of Hemoglobin A1c in 2007-2010 compared to 1999-2006. After careful evaluation of participant data, laboratory quality control data and non-NHANES A1c studies, a cause for this shift in the distribution of Hemoglobin A1c could not be identified. Therefore, the Hemoglobin A1c data for 2007-2008 (GHB_E) and 2009-2010 (GHB_F) were re-released in March 2012 without changes to the data. The user will need to carefully consider the information presented in this analytic note when analyzing Hemoglobin A1c data from 1999-2010. Two-year data are used as a placeholder to provide the latest data available and will be replaced with four-year data when available. Two-year and four-year data are not comparable. Different age adjustment groups are used for the two year and four year data. Two-year estimates are generally less stable and reliable than four-year estimates.
Description of Changes Since the Healthy People 2020 Launch

The baseline was revised from 16.2% to 17.9% due to a change in programming. A cross over regression adjustment was used for the original baseline and has since been removed following the NHANES guidance for these data. The target has been adjusted using the original target setting method of 10% improvement and was revised from 14.6% to 16.1% accordingly.