National Standards for Diabetes Self-Management Education

Abstract

Diabetes self-management education (DSME) is a critical element of care for all people with diabetes and is necessary in order to improve patient outcomes. The National Standards for DSME are designed to define quality diabetes self-management education and to assist diabetes educators in a variety of settings to provide evidence-based education. Because of the dynamic nature of health care and diabetes-related research, these Standards are reviewed and revised approximately every 5 years by key organizations and federal agencies within the diabetes education community.A Task Force was jointly convened by the American Association of Diabetes Educators and the American Diabetes Association in the summer of 2006. Additional organizations that were represented included the American Dietetic Association, the Veteran's Health Administration, the Centers for Disease Control and Prevention, the Indian Health Service, and the American Pharmaceutical Association. Members of the Task Force included a person with diabetes; several health services researchers/ behaviorists, registered nurses, and registered dietitians; and a pharmacist.The Task Force was charged with reviewing the current DSME standards for their appropriateness, relevance, and scientific basis. The Standards were then reviewed and revised based on the available evidence and expert consensus. DEFINITION ANDOBJECTIVES -Diabetes self-management education (DSME) is the ongoing process of facilitating the knowledge, skill, and ability necessary for diabetes self-care. This process incorporates the needs, goals, and life experiences of the person with diabetes and is guided by evidence-based standards. The overall objectives of DSME are to support informed decision-making, self-care behaviors, problem-solving and active collaboration with the health care team and to improve clinical outcomes, health status, and quality of life.GUIDING PRINCIPLES -Before the review of the individual Standards, the Task Force identified overriding principles based on existing evidence that would be used to guide the review and revision of the DSME Standards. These are:1. Diabetes education is effective for improving clinical outcomes and quality of life, at least in the short-term (1-7). 2. DSME has evolved from primarily didactic presentations to more theoretically based empowerment models (3,8). 3. There is no one "best" education program or approach; however, programs incorporating behavioral and psychosocial strategies demonstrate improved outcomes (9 -11). Additional studies show that culturally and ageappropriate programs improve outcomes (12-16) and that group education is effective (4,6,7,17,18). 4. Ongoing support is critical to sustain progress made by participants during the DSME program (3,13,19,20). 5. Behavioral goal-setting is an effective strategy to support self-management behaviors (21). STANDARDSStructure Standard 1. The DSME entity will have documentation of its organizational structure, mission statement, and goals and will recognize and support quality DSME ...

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