Improving Diabetes Care Quality

My Quality Improvement (MyQI)

After reviewing your MONAHRQ-generated information for diabetes, you may be ready to take steps to improve the quality of care of diabetes in your area.

The MyQI Improving Diabetes Care Quality portal provides a framework, action steps, and resources for planning and implementing initiatives to improve the quality of diabetes care in the community, thereby reducing hospitalizations for diabetes patients.

The goals of improving the quality of diabetes care are to close gaps between current and best medical practice, improve access to care, and eliminate disparities.

Resources and links in this portal answer these questions: 

Why is Quality Diabetes Care Important?

The quality of diabetes care can vary widely across communities and population groups. Gaps in care can lead to complications or death and can increase costs.

Information from government agencies illustrates why diabetes has been a target for quality improvement efforts:

Toolkit Icon The prevalence has been increasing.

Toolkit Icon Obesity increases the risk for diabetes. Over the past 20 years, obesity has dramatically increased in the U.S.

learn more icon There are wide racial and ethnic disparities in diabetes diagnosis, treatment, and outcomes (after linking to the NHQR report, see page 50 for diabetes information).

Toolkit Icon Diabetes can be effectively treated and controlled.

Toolkit Icon Poorly controlled diabetes is costly.

learn more icon Diabetes complications are preventable.

Toolkit Icon More information on the importance of improving the quality of care for diabetes is available from AHRQ.


What is Diabetes?

Diabetes is a disease in which blood sugar levels are too high because the body does not produce or properly use insulin. Effective blood sugar management can delay the onset of diabetes.

Persons with diabetes are at risk for serious complications, including blindness, leg amputations, kidney failure, and premature death. A growing number of people are affected by diabetes each year, but it can take several years before the warning signs are noticed and the disease is diagnosed.

Learn more by following the links below.

learn more icon The National Institute of Diabetes and Digestive and Kidney Diseases describes how diabetes is diagnosed and treated, differences between types 1 and 2, and ways to manage the disease.

Toolkit Icon Link to resources on diabetes prevention, risk factors, and complications from the NIH's MedlinePlus.

Audio Icon Prevalence, risk factors, symptoms, and control of diabetes are discussed in this diabetes podcast from the Centers for Disease Control and Prevention (CDC).

Audio Icon Link to other CDC podcasts by entering "diabetes" as a search term.

Video Icon This CDC video features simple steps that can delay or prevent type 2 diabetes.


How Common is Diabetes?

More than 23 million people in the U.S. suffer from diabetes.

Follow these links for additional diabetes statistics from the CDC:

learn more icon Diabetes prevalence, incidence, mortality, costs, and complications

Toolkit Icon State and national trends, county level estimates, national surveillance data, and national estimates on diabetes-related complications

learn more icon Information about health disparities in diabetes among minority populations


How Can I Plan for Diabetes Quality Improvement?

Steps Toward Improving Health Care Quality

Step 1. Create a vision and provide leadership for quality improvement

Collect information

Toolkit Icon Select a state in AHRQ’s State Snapshots "Focus on Diabetes" tool to explore the quality of diabetes care.

learn more icon Characteristics of hospital stays for patients with diabetes in 2008 are described in this HCUP Statistical Brief.

Toolkit Icon Find data on diabetes prevalence and trends from the CDC’s Behavioral Risk Factor Surveillance System

  • Click on "Chronic Disease Indicators" to view state diabetes rates compared to national benchmarks. Then:
  1. Select state/area of interest
  2. Enter comparison state of interest
  3. Select indicator category "diabetes"

learn more icon Information on state laws and programs, coverage regulations, and federal funding related to diabetes is available from the National Conference on State Legislators.

  • Use their interactive map to learn about private insurance diabetes coverage requirements in your state.


Make the business case

learn more icon This Commonwealth Fund Field Report analyzes how disease management programs lead to cost savings.

learn more icon The Economic Costs of Diabetes in the U.S. in 2007 measures the economic burden of the disease.

learn more icon Research into the impacts of the Chronic Care Model on disease management costs is reviewed in this article in the Journal of the American Medical Association. Diabetes care programs are discussed.

Toolkit Icon The Center for Health Care Strategies developed an ROI Calculator for Medicaid Quality Initiatives for several conditions, including diabetes. Although based on limited data, users may find the calculator a good starting point.

Toolkit Icon A User Guide is available.

Toolkit Icon Access information on hospital care for diabetes using AHRQ’s HCUPnet, a free, online query system.


Identify community partnerships and champions

learn more icon An advisory council to the Indiana Diabetes Prevention and Control Program helped develop their statewide initiative for improving diabetes care quality through data surveillance and community outreach.

Toolkit Icon Tools and strategies for planning and assessing clinic-community partnerships for diabetes care are available in this report funded by the Robert Wood Johnson Foundation.

learn more icon Select here for a report summary.

learn more icon This article in the American Journal of Public Health shows how interventions designed through community partnerships can positively affect diabetes outcomes among population subgroups.


Step 2. Work in partnership with champions/stakeholders

Present the process

Toolkit Icon The Institute for Healthcare Improvement shows you how the Plan-Do-Study-Act model can accelerate quality improvement. It can be applied to diabetes initiatives.

learn more icon Click on a link to learn from experiences of others in designing diabetes quality improvement initiatives targeted to specific populations. All projects are CDC-funded.

learn more icon Translating Research Into Action for Diabetes

learn more icon Native Diabetes Wellness Program

learn more icon U.S. Mexico Border Diabetes Prevention and Control Project


Design the intervention

Toolkit Icon The California Diabetes Program provides a comprehensive framework with checklists, flow charts, training presentations, care guidelines, and a patient diabetes health record card to assist clinicians and organizations.

learn more icon Learn about the value that community health workers bring to diabetes management programs and how to best utilize this resource.

Toolkit Icon The CDC’s Taking Charge of Your Diabetes action plan can help patients and providers manage diabetes and its complications.

learn more icon Resources and information on community-based diabetes programs are available from the American Diabetes Association.

Toolkit Icon Utilize the CDC's Diabetes Indicators and Data Sources Internet Tool to support surveillance, epidemiology, and program evaluation.


Step 3. Implement improvement through the partnership

Apply the intervention

Toolkit Icon Expand diabetes screening and health education to undiagnosed and at-risk people in your community with tools from the National Diabetes Education Program.

learn more icon The Improving Diabetes Efforts Across Language and Literacy project is targeted to patients with low health literacy or limited English.

Toolkit Icon Health care workers can use the Training Manual to empower patients with effective diabetes management skills.

learn more icon The Diabetes Prevention Program demonstrated the positive effects and long-term benefits of lifestyle changes in delaying or avoiding type 2 diabetes and reducing risk factors for cardiovascular disease.


Assess the impact

learn more icon Learn how a disease management program successfully decreased short-term costs and clinical outcomes for diabetes patients.

learn more icon This Framework for Program Evaluation in Public Health from the CDC can be applied to diabetes care quality initiatives.

learn more icon The Robert Wood Johnson Foundation provides this guide to help disease management programs aimed at Medicaid and high-risk patients measure their economic impact.


Spread successful change

learn more iconImproving Chronic Illness and Care, sponsored by The Robert Wood Johnson Foundation, shares strategies for coalitions to improve regional health care quality.

learn more iconLink to expert medical advice, diabetes facts, and patient support materials from the New York City Health and Hospital Corporation at their Diabetes Wellness Center Website.

learn more iconDevelop skills to spread organizational change using frameworks from the Institute for Healthcare Improvement.


What Additional Diabetes Resources are Available?

State and public health planners

States can help create a vision for positive change, work with key stakeholders, create quality interventions, and assess the impacts.

learn more icon The New York State Health Foundation has published reports on state-wide initiatives and policies for diabetes prevention and management.

learn more icon Programs that promote diabetes risk reduction are featured.

learn more icon Key facts and figures about diabetes and interesting resources about dietary sodium, physical activity and nutrition are available.

Toolkit Icon The Texas Diabetes Program/Council provides comprehensive tools for stakeholders and constituents involved with diabetes care.

learn more icon Utah’s Diabetes Prevention and Control Program is a state-wide effort to improve awareness of diabetes risk factors, prevention, and disease control among high-risk populations.


Communities and coalitions

Quality improvement leaders cannot accomplish their task alone. Networks of support, including coalitions and advisory groups, are critical to successful diabetes quality improvement programs.

learn more icon This article in the American Journal of Preventative Medicine shows how to complete a needs assessment in African-American communities at high-risk for developing diabetes.

learn more icon Diabetes health educators can find recently revised national standards of diabetes management education in this article in the Diabetes Care journal.

Toolkit Icon The Wisconsin Collaborative Diabetes Quality Improvement Project can serve as a model for collaborative approaches. You can link to a wealth of resources, including:

Toolkit Icon Training ideas, webcasts and slides

Toolkit Icon Essential diabetes care guidelines in English and Spanish.

Toolkit Icon Information about promoting worksite wellness.


Diabetes quality improvement research

learn more icon This study in Health Affairs measured the cost-effectiveness of Diabetes Disease Management programs.

learn more icon An analysis of 66 studies in the Journal of the American Medical Association found that most quality improvement strategies for diabetes care improved glycemic control.


Other Useful Diabetes Resources

learn more icon Learn about the latest diabetes research from the National Institute of Diabetes and Digestive and Kidney Diseases.

learn more icon The American Diabetes Association provides information, research funding, and community services to people living with or interested in diabetes.

learn more icon The Diabetes Care Journal publishes articles on diabetes awareness, research, and health care quality.

learn more icon This series of HCUP Statistical Briefs reports on data related to diabetes care in hospitals.


Page last reviewed October 2014
Internet Citation: Improving Diabetes Care Quality: My Quality Improvement (MyQI). October 2014. Agency for Healthcare Research and Quality, Rockville, MD.