Percentage of clients with type 2 diabetes mellitus who are up to date with HbA1c (glycated hemoglobin) blood glucose monitoring

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Diabetes is one of the most common chronic diseases affecting people living in Canada.

Around 3.7 million people in Canada older than 1 year live with diagnosed diabetes (9.4% of the population).¹ In addition, over 6% of adults in Canada live with prediabetes, which gives them a higher chance of developing type 2 diabetes.

The number of people living with diabetes is expected to continue to increase as the population in Canada ages and grows. This will result in increased costs that affect society, individuals, communities, and health care systems.

Additionally, Indigenous peoples (First Nations, Inuit, Métis, and Urban Indigenous people) are among the highest-risk populations in Canada for diabetes and related complications. Effective prevention strategies should be grounded in the social, cultural, and health service contexts of a community.

This indicator was included as a result of work done in partnership with the Indigenous Primary Health Care Council but is applicable to all interprofessional primary care practice models.

Key resource

Ontario Health Quality Standard for Prediabetes and Type 2 Diabetes

Change Ideas

Review federal and provincial standards or guidelines on type 2 diabetes

Visit Ontario Health’s Quality Standard for Prediabetes and Type 2 Diabetes landing page, which includes access to the full Quality Standard, Patient Guide, Placemat (quick reference tool), and other helpful resources.
Review clinical practice guidelines from Diabetes Canada, including:

Utilize your electronic medical record (EMR) system to identify and track patients with type 2 diabetes in your practice to ensure they are up to date with HbA1c blood glucose monitoring

Review your most recent MyPractice Primary Care Report to help focus your quality improvement efforts
Run a search in your practice’s EMR system using diabetes billing codes to generate a list of patients with diabetes

Contact OntarioMD Peer Leaders, who provide a complimentary support service for optimizing EMR use

Implement a reminder system to help patients stay up to date with monitoring

Contact OntarioMD Peer Leaders

Utilize community supports for patients

Connect patients with local Diabetes Education Programs
In addition to education and support, Diabetes Education Programs teach self-management skills
Encourage use of My Diabetes Passport. This tool helps patients set goals, and record past and future HbA1c test results

Improve awareness of and make use of guidelines, education, and prevention resources for Indigenous peoples

Diabetes Canada clinical practice guidelines

Type 2 Diabetes and Indigenous Peoples

Indigenous Diabetes Health Circle provides diabetes education, prevention and management in Indigenous communities in Ontario, both on- and off-reserve

Indigenous Diabetes Health Circle Diabetes Wellness Workers promote diabetes awareness from an Indigenous perspective and assist Indigenous communities in identifying appropriate resources and services
Foot care and eye care resources

Knowledge Department combines “traditional wisdom with current diabetes education, incorporating First Nations, Inuit, Métis and mainstream influences.” This program supports frontline workers in planning, preparing, and presenting relevant information about diabetes and Indigenous perspectives on health and wellness.

¹Reference: