2017 National Standards for Diabetes Self-Management Education and Support

Abstract

The purpose of this study is to review the literature for Diabetes Self-Management Education and Support (DSMES) to ensure the National Standards for DSMES (Standards) align with current evidence-based practices and utilization trends. Methods The 10 Standards were divided among 20 interdisciplinary workgroup members. Members searched the current research for diabetes education and support, behavioral health, clinical, health care environment, technical, reimbursement, and business practice for the strongest evidence that guided the Standards revision. Results Diabetes Self-Management Education and Support facilitates the knowledge, skills, and ability necessary for diabetes self-care as well as activities that assist a person in implementing and sustaining the behaviors needed to manage their condition on an ongoing basis. The evidence indicates that health care providers and people affected by diabetes are embracing technology, and this is having a positive impact of DSMES access, utilization, and outcomes. Conclusion Quality DSMES continues to be a critical element of care for all people with diabetes. The DSMES services must be individualized and guided by the concerns, preferences, and needs of the person affected by diabetes. Even with the abundance of evidence supporting the benefits of DSMES, it continues to be underutilized, but as with other health care services, technology is changing the way DSMES is delivered and utilized with positive outcomes.

A systematic review exploring characteristics of lifestyle modification interventions in newly diagnosed type 2 diabetes for delivery in community pharmacy†

“…Intervention facilitators and delivery skills are also important factors to consider in the delivery of structured education . In this review, highly skilled personnel including physicians, diabetes nurses, dietitians and nutritionists were used to deliver the interventions.…”

“…In this review, highly skilled personnel including physicians, diabetes nurses, dietitians and nutritionists were used to deliver the interventions. Although this reflects the multidisciplinary approach recommended by evidence, the interventions did not reflect more recent guidelines which demonstrate the expansion of the role of facilitators over the recent years to include other disciplines such as pharmacists . In the United States, the 2017 national standards for diabetes self‐management education and support (DESMES) recommends that at least one of the team members responsible for facilitating DESMES services should be a registered nurse, registered dietitian nutritionist or pharmacist with training and experience .…”

Five-Year Cost-effectiveness of the Multidisciplinary Risk Assessment and Management Programme–Diabetes Mellitus (RAMP-DM)

“…First, the multidisciplinary RAMP-DM team provided more education, including education on disease knowledge, self-care, and lifestyle, through nurse intervention, the Patient Empowerment Programme (PEP) (22), the smoking cessation, and a dietitian. Diabetes self-management education has been proved to prevent or delay the complication of diabetes (23-27); thus, the American Diabetes Association recommended standards for diabetes self-management education, which requires a multidisciplinary team, including physicians, nurses, a dietitian, and pharmacists, to provide structured, individual, and ongoing education to patients (28). The interventions of RAMP-DM met the recommended standards from the American Diabetes Association.…”

4. Lifestyle Management:Standards of Medical Care in Diabetes—2018

“…Patient performance of self-management behaviors as well as psychosocial factors impacting the person's self-management should be monitored. DSMES and the current national standards guiding it (1,3) are based on evidence of benefit. Specifically, DSMES helps people with diabetes to identify and implement effective self-management strategies and cope with diabetes at the four critical time points (described below) (1).…”