DM020 - Diabetes (without frailty) with HbA1c less than or equal to 58

The codes referenced in this article are taken from the NHS Technology Reference Update Distribution (
TRUD). Not all of these may be present or selectable in all clinical systems.
Indicator definition
Indicator ID
| |
DM020
| The percentage of patients with diabetes, on the register, without moderate or severe frailty in whom the last IFCC-HbA1c is 58 mmol/mol or less in the preceding 12 months. |
What do the business rules mean?
What makes a patient eligible?
Patients are included in DM020 if they:
- are on the Diabetes register
- are not living with moderate or severe frailty
What must I do to achieve the indicator
To meet the criteria for DM020, eligible patients must have had:
- an HbA1c in the contract year that is less than or equal to 58
What will remove patients from eligibility?
- Patients who do not have an HbA1c recorded during this contract year, but they do have a serum fructosamine result recorded
- Patients who are coded for maximal tolerated diabetes treatment in the contract year
- Patients for whom diabetes quality indicator care was unsuitable in the contract year
- Patients who chose not to receive a blood test in the contract year
- Patients who chose not to receive diabetes quality indicator care in the contract year
- Patients who have been invited twice (at least 7 days apart) for review with no subsequent HbA1c result
- Patients whose most recent HbA1c result in the contract year was followed by two invites at least 7 days apart (ie: a 6 month review or a raised result which needs re-checking)
- Patients who were diagnosed with diabetes in the last 9 months of the contract year
- Patients who were newly registered with the practice in the last 9 months of the contract year

If a patient achieves the
indicator at any point during the year, any exclusions that have also been
added are ignored.
SNOMED codes used in this indicator

The codes referenced in this article are taken from the NHS Technology Reference Update Distribution (TRUD). Not all of these may be present or selectable in all clinical systems.
Serum fructosamine codes (SERFRUC_COD)
SNOMED code | SNOMED code description |
1006751000000102 | Serum fructosamine level |
13711000237108 | Substance concentration of fructosamine in serum |
14201000237100 | Substance concentration of fructosamine in plasma |
Codes for maximal tolerated diabetes treatment (DMMAX_COD)
SNOMED code | SNOMED code description |
407569005 | Patient on maximal tolerated therapy for diabetes |
Codes for diabetes quality indicator care unsuitable for patient (DMPCAPU_COD)
SNOMED code | SNOMED code description |
717421000000100 | Excepted from diabetes quality indicators - patient unsuitable |
Codes indicating the patient has chosen not to receive a blood test (BLDTESTDEC_COD)
SNOMED code | SNOMED code description |
116471000119100 | Blood test declined
|
Codes indicating the patient has chosen not to receive diabetes quality indicator care (DMPCADEC_COD)
SNOMED code | SNOMED code description |
716031000000106 | Excepted from diabetes quality indicators - informed dissent |
Invite for diabetes care review codes (DMINVITE_COD)
SNOMED code | SNOMED code description |
1109921000000106 | Quality and Outcomes Framework quality indicator-related care invitation |
1110921000000100 | Quality and Outcomes Framework diabetes mellitus quality indicator-related care invitation |
143401000000102 | Quality and Outcomes Framework diabetes mellitus quality indicator-related care invitation using preferred method of communication |
705072004 | Diabetes monitoring invitation by short message service text messaging |
1066911000000100 | Diabetes monitoring short message service text message first invitation |
1066921000000106 | Diabetes monitoring short message service text message second invitation |
1066931000000108 | Diabetes monitoring short message service text message third invitation |
1083111000000108 | Diabetes monitoring invitation email |
185756006 | Diabetes monitoring first letter |
185757002 | Diabetes monitoring second letter |
185758007 | Diabetes monitoring third letter |
185759004 | Diabetes monitoring verbal invite |
185760009 | Diabetes monitoring telephone invite |
310425007 | Diabetes monitoring invitation |