As the leader of a patient’s care team, you're instrumental in identifying early interventions to effectively manage and treat the disease. You also need resources to help patients prevent diabetes. Strategies will often depend on patient symptoms, age, and comorbidities, in addition to social determinants of health. Access to nutritional food and safe spaces to exercise are major factors in preventing and slowing disease progression.
Effective care coordination ensures patient-centered and high-quality care.
ACP Guideline: Oral pharmacologic treatment of diabetes
(Endorsed by the AAFP)
Guiding Principles for the Care of People With or At-Risk of Diabetes (Supported by the AAFP)
Coding & Payment: How to Support Chronic Care Management Services
Coordinated Care and Care Management Tools and Resources
Quality Measures: Identify Opportunities to Improve Patient Care
The AAFP in conjunction with the Core Quality Measure Collaborative promotes measure harmonization across programs and payers. Listed here are the measures currently selected to evaluate diabetes.
|Diabetes Quality Measures|
|0059||Comprehensive Diabetes Care: HbA1c Poor Control (>9.0%)||National Committee for Quality Assurance||*eCQM version available; Telehealth eligible|
|0055||Comprehensive Diabetes Care: Eye Exam||National Committee for Quality Assurance||*eCQM version available; Telehealth eligible|
|0057||Comprehensive Diabetes Care: Hemoglobin A1c (HbA1C) testing+||National Committee for Quality Assurance|
|0062||Comprehensive Diabetes Care: Medical Attention for Nephropathy||National Committee for Quality Assurance||*eCQM version available; Telehealth eligible|
Consensus Report: Diabetes Self-management Education and Support in Adults With Type 2 Diabetes
AAFP TIPS: Quality Improvement
Train your team on the benefits, concepts, and steps of the quality improvement process to enhance the care you provide. Includes two online learning courses, three customizable slide decks, and six downloadable tools. CME: 1 AAFP Prescribed credit; Free to members.
AAFP TIPS : Continuous Glucose Monitoring (CGM)
Learn about CGM, identify which patients may benefit, evaluate patient technology-readiness, and access numerous resources. Includes workflow, billing and coding EHR documentation, and authorization best-practices for diabetes care developed from research. CME 2 AAFP Prescribed credits; Free.
AAFP TIPS: Standing Orders
Learn how to initiate a Standing Orders quality improvement project in your practice to improve clinical efficiency. Includes four online learning courses, two customizable slide decks, and 11 downloadable tools. CME: 1 AAFP Prescribed credit; Free to members.
Developed by the AAFP and approved in November 2021
Continuing Medical Education
View applicable courses in:
AAFP CME Endocrinology
AAFP CME Cardiometabolic Conditions
Diabetes Topic Module
Helping a Family Member Who Has Diabetes
Diabetes and Exercise
Diabetes and Nutrition
Monitoring Your Blood Sugar Level
*Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2020. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2020. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf Accessed October 5, 2021.
**Dall TM, Yang W, Halder P, et al. The economic burden of elevated blood glucose levels in 2012: diagnosed and undiagnosed diabetes, gestational diabetes mellitus, and prediabetes. Diabetes Care. 2014;37(12):3172-3179.