Medical studies demonstrate that patients who participate in diabetes self-management education (DSME) programs are more likely to:
- Use primary care and preventive services
- Be more proactive in their care
- Have delayed onset or escalation of diabetes
- Take medications as prescribed
- Have improved clinical outcomes, such as better control of their HBA1c levels, blood pressure and LDL cholesterol, and
- Have lower health care related costs
DiamC is the only diabetes program in Louisiana with a program in diabetes self-management education (DSME) certified by the American Diabetes Association (ADA) and the American Association of Diabetes Educators (AADE). These certifying organizations recognize DiamC for providing evidenced-based education and support services standards adopted by a national task force of experts in diabetes care and management.
In 2015, a Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics recommended DSME be provided to all patients with Type 2 diabetes at these four critical times.
Four critical times to assess, provide, and adjust diabetes self-management education and support:
When primary care provider or specialist should consider referral:
When primary care provider or specialist should consider referral:
- Newly diagnosed. All newly diagnosed individuals with type 2 diabetes should receive DSME/S
- Ensure that both nutrition and emotional health are appropriately addressed in education or make separate referrals
2
Annual assessment of education, nutrition, and emotional needs
When primary care provider or specialist should consider referral:
- Needs review of knowledge, skills, and behaviors
- Long-standing diabetes with limited prior education
- Change in medication, activity, or nutritional intake
- HbA1c out of target
- Maintain positive health outcomes
- Unexplained hypoglycemia or hyperglycemia
- Planning pregnancy or pregnant
- For support to attain and sustain behavior change(s)
- Weight or other nutrition concerns
- New life situations and competing demands
3
When new complicating factors influence self-management
When primary care provider or specialist should consider referral:
Change in:
- Health conditions such as renal disease and stroke, need for steroid or complicated medication regimen
- Physical limitations such as visual impairment, dexterity issues, movement restrictions
- Emotional factors such as anxiety and clinical depression
- Basic living needs such as access to food, financial limitations
4
When transitions in care occur
When primary care provider or specialist should consider referral:
Change in:
- Living situation such as inpatient or outpatient rehabililtation or now living alone
- Medical care team
- Insurance coverage that results in treatment change
- Age-related changes affectiving cognition, self-care, etc.
