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Research Letter
Health Care Policy and Law
November 2016

Inclusion of Hypoglycemia in Clinical Practice Guidelines and Performance Measures in the Care of Patients With Diabetes

Author Affiliations
  • 1Knowledge and Evaluation Research Unit in Endocrinology, Mayo Clinic, Rochester, Minnesota
  • 2Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota
  • 3Division of Endocrinology, Department of Internal Medicine, University Hospital “Dr Jose E. Gonzalez,” Autonomous University of Nuevo Leon, Monterrey, Mexico
  • 4Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota
  • 5Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
  • 6Section of Endocrinology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
JAMA Intern Med. 2016;176(11):1714-1716. doi:10.1001/jamainternmed.2016.5046

Health care organizations use publicly reported performance measures for quality measurement and improvement and pay-for-performance initiatives.1 These measures should ideally promote high-quality care that is evidence based and congruent with clinical practice guidelines. However, they should also reward patient-centered care that yields optimal outcomes with the lowest risk of harm.2 For patients with both type 1 and type 2 diabetes, high-quality care should therefore minimize the risk of hypoglycemia.2 The degree to which existing performance measures are aligned with guidelines, particularly in regard to hypoglycemia avoidance, is uncertain. We therefore conducted an environmental scan to assess the inclusion and prioritization of hypoglycemia in contemporary clinical guidelines and performance measures for patients with diabetes.

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