Navigating the diabetes atlas

(Edmonton) A report just released by the Alberta Diabetes Surveillance System shows a need for more teamwork between patients and their health-care providers to aid Albertans with getting the laboratory tests necessary to help manage and prevent long-term complications of the disease.

According to the Alberta Diabetes Atlas 2011, many Albertans who have diabetes are not getting the recommended number of laboratory tests. This is one of the findings of the report that shows that the recommended tests for sugar control, kidney disease and cholesterol are under-utilized.

"This is consistent with other quality indicators, where the data suggests we are not reaching guideline recommendations," says Jeff Johnson, a researcher with the University of Alberta's School of Public Health. "The onus is on patients, providers and the system to work together to make sure that laboratory tests are being done."

The results included in the two previous versions of the Atlas were drawn from administrative data made available by Alberta Health and Wellness. This is the first time that the Atlas has included other sources of data, including laboratory data.

"Our desire was to enhance the service we are providing to practitioners through the Atlas," explains Johnson. In the past, the results reported were more focused on incidence, prevalence, mortality and health-care utilization by patients with diabetes. "By including lab data, we are able to look at issues related to quality of care."
Johnson says that each Canadian province produces something like the Atlas where the data are generally presented at an aggregate level. The Alberta version is innovative and unique, offering an enhanced report that is systematically and regularly updated.

"We've extended the scope, content and depth of the report," he explains. "We can identify trends over time, as well as across geography, age, sex and by Aboriginal status." By looking at geographic zones, for example, it becomes possible to identify "hot spots" in the Alberta diabetes population.
With enhancements to the 2011 version, such as the inclusion of laboratory data, the Atlas has become a vital tool for front line health-care providers and policy-makers.

For instance, by monitoring the frequency of key laboratory tests conducted for diabetes patients, it is possible to evaluate the risk for long-term complications on a population level. Blood sugar control, kidney function, and lipids/cholesterol levels are indicators of potential complications for diabetes. At the level of the health-care system, monitoring the use of these tests will help inform managers regarding overall quality of care.

"All of these things are proven to help reduce long-term complications," says Johnson.

The Atlas is intended to help health-care practitioners and policy-makers make decisions about implementing and evaluating programs aimed at improving the quality of care. "We hope that they will be more informed about the ongoing and contemporary issue of diabetes," Johnson says.
Johnson's team is looking at potential of extending the surveillance system.

"We have the machinery in place. This system could easily be expanded beyond diabetes to include other related chronic diseases."
If that happens, the enhanced surveillance system could be used to evaluate outcomes for health-care strategies related to reducing chronic disease among Albertans.

The Alberta Diabetes Atlas is a product of the Alberta Diabetes Surveillance System and is produced through a partnership between the University of Alberta's School of Public Health, the Institute of Health Economics and Alberta Health and Wellness.