After weighing the quality of evidence, from rigorous double-blind clinical trials to expert opinion, recommendations are drafted, reviewed, and submitted for approval to the Association's Executive Committee; they are then revised on a regular basis, and subsequently published in the Association's professional journal Diabetes Care. Fill your senses with Southwestern and Mexican dishes that are easy, fulfilling, and—surprisingly—healthy. Learn the top 3 questions to ask your doctor about the link between type 2 diabetes and cardiovascular disease.
Online Diabetes Care For The Older Patient A Practical Handbook
Are You At Risk? Donate today Other Ways to Donate: Chat Online Chat Closed. Recent education research endorses the inclusion of practical problem-solving approaches, collaborative care, psychosocial issues, behavior change, and strategies to sustain self-management efforts 12 , 13 , 19 , 74 , 86 , 98 — The following core topics are commonly part of the curriculum taught in comprehensive programs that have demonstrated successful outcomes 2 , 3 , 5 , 91 , — The content areas will be able to be adapted for all practice settings.
Approaches to education that are interactive and patient centered have been shown to be effective 12 , 13 , — Also crucial is the development of action-oriented behavioral goals and objectives 12 — 14 , Creative, patient-centered, experience-based delivery methods—beyond the mere acquisition of knowledge—are effective for supporting informed decision making and meaningful behavior change and addressing psychosocial concerns , The diabetes self-management, education, and support needs of each participant will be assessed by one or more instructors.
The participant and instructor s will then together develop an individualized education and support plan focused on behavior change.
The assessment process is used to identify what those needs are and to facilitate the selection of appropriate educational and behavioral interventions and self-management support strategies, guided by evidence 2 , 63 , — The education and support plan that the participant and instructor s develop will be rooted in evidence-based approaches to effective health communication and education while taking into consideration participant barriers, abilities, and expectations.
The instructor will use clear health communication principles, avoiding jargon, making information culturally relevant, using language- and literacy-appropriate education materials, and using interpreter services when indicated , — Evidence-based communication strategies such as collaborative goal setting, motivational interviewing, cognitive behavior change strategies, problem solving, self-efficacy enhancement, and relapse prevention strategies are also effective , — Periodic reassessment can determine whether there is need for additional or different interventions and future reassessment 6 , 72 , — A variety of assessment modalities, including telephone follow-up and other information technologies e.
Evidence suggests that the development of standardized procedures for documentation, training health professionals to document appropriately, and the use of structured standardized forms based on current practice guidelines can improve documentation and may ultimately improve quality of care , — The participant and instructor s will together develop a personalized follow-up plan for ongoing self-management support. While DSME is necessary and effective, it does not in itself guarantee a lifetime of effective diabetes self-care To sustain the level of self-management needed to effectively manage prediabetes and diabetes over the long term, most participants need ongoing DSMS Some patients benefit from working with a nurse case manager 6 , 86 , Case management for DSMS can include reminders about needed follow-up care and tests, medication management, education, behavioral goal setting, psychosocial support, and connection to community resources.
The effectiveness of providing DSMS through disease management programs, trained peers and community health workers, community-based programs, information technology, ongoing education, support groups, and medical nutrition therapy has also been established 7 — 11 , 86 , 88 — 90 , , — While the primary responsibility for diabetes education belongs to the provider s of DSME, participants benefit by receiving reinforcement of content and behavioral goals from their entire health care team Additionally, many patients receive DSMS through their primary care provider.
The provider s of DSME and DSMS will monitor whether participants are achieving their personal diabetes self-management goals and other outcome s as a way to evaluate the effectiveness of the educational intervention s , using appropriate measurement techniques. Effective diabetes self-management can be a significant contributor to long-term, positive health outcomes.
The AADE Outcome Standards for Diabetes Education specify behavior change as the key outcome and provide a useful framework for assessment and documentation. The AADE7 lists seven essential factors: Differences in behaviors, health beliefs, and culture as well as their emotional response to diabetes can have a significant impact on how participants understand their illness and engage in self-management. Assessments of participant outcomes must occur at appropriate intervals. For some areas, the indicators, measures, and time frames will be based on guidelines from professional organizations or government agencies.
The provider s of DSME will measure the effectiveness of the education and support and look for ways to improve any identified gaps in services or service quality using a systematic review of process and outcome data.
National Standards for Diabetes Self-Management Education and Support
Diabetes education must be responsive to advances in knowledge, treatment strategies, education strategies, and psychosocial interventions, as well as consumer trends and the changing health care environment. By measuring and monitoring both process and outcome data on an ongoing basis, providers of DSME can identify areas of improvement and make adjustments in participant engagement strategies and program offerings accordingly.
The Institute for Healthcare Improvement suggests three fundamental questions that should be answered by an improvement process Once areas for improvement are identified, the DSME provider must designate timelines and important milestones including data collection, analysis, and presentation of results Measuring both processes and outcomes helps to ensure that change is successful without causing additional problems in the system. Outcome measures indicate the result of a process i. Process measures are often targeted to those processes that typically impact the most important outcomes.
No potential conflicts of interest relevant to this article were reported. This version received final approval in July National Center for Biotechnology Information , U. Journal List Diabetes Care v. Published online Dec Piette , PhD, 13 Andrew S. Author information Copyright and License information Disclaimer.
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See " National standards for diabetes self-management education. This article has been cited by other articles in PMC. In particular, there are three areas in which the Task Force recommends additional research: What training should be required for those community, lay, or peer workers without training in health or diabetes who are to participate in the provision of DSME and to provide DSMS?
Providers of DSME can help address this issue by: Clarifying the specific population to be served. Understanding the community, service area, or regional demographics is crucial to ensuring that as many people as possible are being reached, including those who do not frequently attend clinical appointments 9 , 17 , 22 — Different individuals, their families, and communities need different types of education and support Identifying access issues and working to overcome them.
It is essential to determine factors that prevent individuals with diabetes from receiving self-management education and support. The assessment process includes the identification of these barriers to access 32 — These barriers may include the socioeconomic or cultural factors mentioned above, as well as, for example, health insurance shortfalls and the lack of encouragement from other health providers to seek diabetes education 35 , Describing the diabetes disease process and treatment options.
Monitoring blood glucose and other parameters and interpreting and using the results for self-management decision making. What are we trying to accomplish? Centers for Disease Control and Prevention. National Diabetes Fact Sheet: Interventions to promote diabetes self-management: Diabetes Educ ; 25 Suppl.
Self-management education for adults with type 2 diabetes: Diabetes Care ; Meta-analysis of randomized educational and behavioral interventions in type 2 diabetes. Diabetes Educ ; Group based training for self-management strategies in people with type 2 diabetes mellitus.
Cochrane Database Syst Rev ; 2: Interventions to improve the management of diabetes in primary care, outpatient, and community settings: An update on the Diabetes Prevention Program. Endocr Pract ; 12 Suppl. Access to diabetes self-management education: Management of hyperglycemia in type 2 diabetes: Evaluating a problem-based empowerment program for African Americans with diabetes: Ethn Dis ; Developing a new generation of ongoing diabetes self-management support interventions: Implementing an empowerment-based diabetes self-management education program. A systematic review of interventions to improve diabetes care in socially disadvantaged populations.
Behavior change interventions delivered by mobile telephone short-message service. Am J Prev Med ; Designing education to improve care. Changes and consistencies in diabetes education over 5 years: Disease-Specific Care Certification Manual.
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Deploying the chronic care model to implement and sustain diabetes self-management training programs. Implementing the chronic care model for improvements in diabetes care and education in a rural primary care practice.
Costs and benefits associated with diabetes education: Health of previously uninsured adults after acquiring Medicare coverage. Diabetes in non-Hispanic white youth: Diabetes Care ; 32 Suppl. Interactive media for diabetes self-management: Med Decis Making ; Community-based peer-led diabetes self-management: Individual patient education for people with type 2 diabetes mellitus. Cochrane Database Syst Rev ; 1: Randomized trial of a literacy-sensitive, culturally tailored diabetes self-management intervention for low-income Latinos: Diabetes in African American youth: Type 1 and type 2 diabetes in Asian and Pacific Islander U.
Training community health workers as diabetes educators for urban African Americans: Prog Community Health Partnersh ; 1: Healthcare costs associated with depression in medically ill fee-for-service Medicare participants. J Am Geriatr Soc ; Results of a successful telephonic intervention to improve diabetes control in urban adults: Effects of pharmacist outpatient interventions on adults with diabetes mellitus: Health care utilization and self-care behaviors of Medicare beneficiaries with diabetes: Popul Health Manag ; Effects of care coordination on hospitalization, quality of care, and health care expenditures among Medicare beneficiaries: A randomized trial of a primary care-based disease management program to improve cardiovascular risk factors and glycated hemoglobin levels in patients with diabetes.
Am J Med ; Most diabetes complications can be prevented or reduced. This new edition of Diabetes Care is a reference source for all aspects of care in the management and understanding of diabetes. It provides a step-by-step guide to diabetes care and includes information on assessment, education, monitoring, and treatment of diabetes across all age groups and ethnic backgrounds.
There are detailed sections on helping patients manage their diabetes in everyday life, extensive advice on the monitoring and adjustment of glucose levels, and discussion on the preventing and coping with emergencies. Focus is primarily on the prevention, detection, and treatment of diabetic tissue damage, including heart disease.
There is also an expanded section on using data and audit to review and improve care. Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription. Please subscribe or login to access full text content.
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