Diabetes: LDL Management & Control (NQF 0064)

EMeasure Name Diabetes: LDL Management & Control EMeasure Id 2857f177-2806-4a86-a015-a359954795b5
Version number 1 Set Id 973d4b13-04ec-4c68-a03f-66df138edeca
Available Date No information Measurement Period January 1, 20xx through December 31, 20xx
Measure Steward National Committee for Quality Assurance
Endorsed by National Quality Forum
Description The percentage of patients 18–75 years of age with diabetes (type 1 or type 2) who had LDL-C <100mg/dL.
Copyright
© National Committee for Quality Assurance. All Rights Reserved
Measure scoring Proportion
Measure type Process
Stratification
None
Risk Adjustment
None
Data Aggregation
Rationale
 This measure assesses the percentage of patients in a specific age demographic who were diagnosed with type 1 or type 2 diabetes and who demonstrate poor lowdensity lipoprotein (LDL) cholesterol levels. Diabetes mellitus (diabetes) is a group of diseases characterized by high blood glucose levels caused by the bodys inability to correctly produce or utilize the hormone insulin . It is recognized as a leading cause of death and disability in the U.S. and is highly underreported as a cause of death. Diabetes of either type may cause life-threatening, life-ending or life-altering complications, including poor cholesterol, specifically LDL. Clinical guidelines recommend lifestyle modifications that include reducing intake of saturated fat, trans fat and cholesterol; weight loss; and increased physical activity (ADA 2009). Statin therapy is suggested for eligible patients whose levels are consistently and significantly higher (ADA 2009). This measure facilitates longterm management of LDL cholesterol levels for patients diagnosed with diabetes. 
Clinical Recommendation Statement
American Diabetes Association: In most adult patients, measure fasting lipid profile at least annually. In adults with low-risk lipid values (LDL cholesterol < 100 mg/dl, HDL cholesterol > 50 mg/dl, and triglycerides < 150 mg/dl), lipid assessments may be repeated every 2 years.
                
ACE/AACE: Aggressive management of dyslipidemia in patients with diabetes mellitus is critical; treat patients to achieve the following goal: LDL-C < 100 mg/dL (< 70 mg/dL is recommended for patients with diabetes mellitus and coronary artery disease). 
Improvement notation
Higher score indicates better quality
Measurement duration
12 month(s)
Reference
Standards of Medical Care in Diabetes - 2009. Diabetes Care January 2009 32:S6-S12; doi:10.2337/dc09S006
Reference
AACE Medical Guidelines for Clinical Practice for the Management of Diabetes Mellitus. Endocrine Practice Vol 13 (Suppl 1) May/June 2007 
Definition
Guidance
The measure expects an LDL test result (Numerator 1) and an LDL value <= 100 mg/dL (Numerator 2). LDL results are acceptable if directly reported from the laboratory, or if calculated using the following logic, but calculation is only acceptable if the Triglyceride value is <=400 mg/dL:

[Total Cholesterol value –High Density Lipoprotein (HDL) value – (Triglyceride value/5)]
            
In the second part of the Numerator 2, the calculated LDL value must use results of total cholesterol, HDL and triglycerides all from the same date.

Table of Contents


Population criteria

Data criteria (QDS Data Elements)

Summary Calculation

Calculation is generic to all measures:



Measure set CLINICAL QUALITY MEASURE SET 2011-2012