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Cascade-of-Care Concept Might Help Plug Gaps in Diabetes Care

Among the 20.4 million diagnosed adult diabetes patients, 95.3% had a usual care provider and 91.7% made 2 or more visits in the past year. In contrast, among undiagnosed adults, 84.5% had a usual care provider and 66.5% reported 2 or more visits in the past year. Among diagnosed adults, 63.7%, 65.5%, 56.6%, and 80.6% met individualized hemoglobin A1c, blood pressure, lipid, and nonsmoking goals, respectively; 26.7% met combined ABC (HbA1c, BP, and LDL cholesterol) targets, and 21.3% met combined ABC targets and did not smoke. Among undiagnosed adults, 77.0%, 57.9%, 36.0%, and 77.9% met hemoglobin A1c, BP, lipid, and nonsmoking goals, respectively; 22.1% met combined ABC targets; and 18.8% met combined ABC targets and were nonsmokers. The authors suggest that the cascade-of-care concept is powerful in helping visualize gaps and disparities across groups and improving engagement and health care quality. — A Cascade of Care for Diabetes in the United States: Visualizing the Gaps, M.K. Ali, K.M. Bullard, E.W. Gregg, and C. del Rio, Annals of Internal Medicine, doi:10.7326/M14-0019, 17 Nov 2014