U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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  Quality of IHS Health Care

Performance Measures

Health Topic: Diabetes
Diabetes affects many American Indians and Alaska Natives (AI/AN). In fact, between 1997 and 2003, the number of AI/AN patients who have diabetes and get their health care from IHS increased by 41%. The high costs of health care along with more patients getting diabetes represent a challenge for IHS.

Between the years of 2002 and 2004, the number of deaths from diabetes in the AI/AN population was almost 3 times higher than all other races.

Patients who have diabetes also are more likely to have heart disease (Cardiovascular Disease), which affects the heart and blood vessels. Heart disease is the number one cause of death for AI/AN patients. It is very important for patients who have diabetes to take care of themselves. You can do this by getting the tests you need. The tests will show how well diabetes is being controlled. Hemoglobin A1c (blood sugar) is one of the tests.

What is a Hemoglobin A1c test?
Hemoglobin A1c measures your blood sugar control over a 3 month period.

Who should get this test?
It is important for people with diabetes to have this test done once a year or more.

Why are blood sugar levels important?
Blood sugar levels show if your diabetes is controlled. Controlling your blood sugar makes you feel better. This can reduce your chances of going blind, losing feeling in your legs and getting amputations. It also reduces your chances of getting kidney disease, going on dialysis, and having a heart attack or stroke.

What is a good Hemoglobin A1c number?
A lower number is a better score.

  • A number lower than 7% shows you have ideal (best) blood sugar control.
  • A number higher than 9.5% shows you have poor blood sugar control.

What is the GPRA measure?
This measure is not an official GPRA measure but is reported annually to OMB and Congress; it is the percentage of IHS AI/AN diabetes patients who had a hemoglobin A1c (blood sugar) test during the year.

How is IHS doing?
The United States has set a goal to test the blood sugar in at least 71.1% of diabetes patients at least twice in the past 12 months by the year 2020 (Healthy People 2020). In 2012 IHS achieved the rate of 84.9% for the proportion of patients diagnosed with diabetes who had their blood sugar tested at least once in the past 12 months.

Percentage of IHS AI/AN Patients with Diabetes  with Blood Sugar Assessed  Note: A higher score is better

View a table of this chart's data.

Year Percent
2002 73
2003 75
2004 77
2005 78
2006 79
2007 79
2008 79
2009 80
2010 82
2011 83.0
2012 84.9
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To see how IHS is doing on this measure at the Area (regional) levels, click here.