International panel proposes standard list of diabetes outcome measures

  • Nano J & al.
  • Diabet Med
  • 2 Mar 2020

  • curated by Miriam Tucker
  • Clinical Essentials
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Takeaway

  • A multinational panel has developed a standard list of 27 diabetes outcomes for use in routine clinical practice to monitor, benchmark, and improve diabetes care.

Why this matters

  • Standardized diabetes care monitoring can improve quality through routine audits and benchmarking.
  • Inconsistencies among measures adopted in different countries hamper this process and undermine international comparisons.

Study design

  • Systematic review of outcome measures for adults with type 1 or type 2 diabetes.
  • Consensus-driven modified Delphi panel, comprising academics, health professionals, and people with diabetes.
  • Validation via external feedback from people with diabetes and health professionals.
  • Funding: Imperial College London Diabetes Centre, Abu Dhabi; JDRF, United States.

Key results

  • Clinical outcome measure domains:
    • Diabetes control, including BP, lipid profile, BMI, and HbA1c.
    • Acute events: diabetic ketoacidosis, hyperosmolar hyperglycemic syndrome, hypoglycemia.
    • Chronic complications: long-term neuropathic, cardiovascular, peripheral arterial, visual, periodontal, erectile.
    • Health services: hospitalizations/emergency visits per year, discharge diagnoses in major diabetes-related categories.
    • Survival: diabetes-related deaths.
  • Patient-reported outcome measures (PROMs): assessed with 5-item WHO Well-Being Index, Patient Health Questionnaire-9 to measure depression, and Problem Areas in Diabetes scale.

Limitations

  • Opinion-based.
  • No feedback from people with diabetes in lower-income countries.
  • Outcome relevance may differ by diabetes type.
  • PROMs may not be uniformly assessed.