Diabetes education is paramount to successful diabetes management. The American Diabetes Association recommends that each individual with diabetes receive diabetes self-management education at their initial diagnosis and thereafter as needed.1 However, provider referral for diabetes self-management education is inconsistent. According to the Centers for Disease Control and Prevention (CDC), “only an estimated 6.8% of privately insured, newly diagnosed adults participated in diabetes self-management education.”2
What is Diabetes Self-Management Education (DSME)?
- Diabetes Self-Management Education is the ongoing education that teaches those with diabetes the fundamentals of diabetes self-care. Patients learn the tools necessary to care for their diabetes as well as how to fit diabetes self-care into their daily routine.
Diabetes Self-Care includes 7 key areas:3
- Healthy Eating
- Being Active
- Taking Medication
- Problem Solving
- Reducing Risks
- Healthy Coping
- DSME is a patient-centered process that takes into consideration patient goals and life experience, both of which help empower patients to make informed decisions. 1
- Diabetes self-management support (DSMS) includes follow-up education/support that takes place after the initial diabetes self-management education. A major goal of DSMS is to assist patients in maintaining behavior change.1
What are the benefits of DSME?
Research has shown that people who receive Diabetes Self-Management Education are more likely to:1,3
- Use primary care and preventive services (i.e. screening tests and shots)
- Take medications as prescribed by their physician
- Control their blood glucose, blood pressure and blood lipids
- Improved A1c (a measure of blood glucose control of the previous 3 months). A1c may be reduced, “by as much as 1 % in people with type 2 diabetes” 1
- Have reduced health care costs
- Attributed to reduced hospital admissions and readmissions as well as delayed onset of chronic complications
- Have an improved sense of well-being and better quality of life
Where and Who provides DSME/DSMS?
Diabetes self-management education are outpatient programs that commonly take place in a hospital setting. As healthcare has continued to advance, so have DSME programs. Programs are now available in the following settings/formats:
- Office practices
- Community health centers
The National Standards for DSME require that one instructor, who has played a role in designing the DSME program, be a “nurse, dietitian, pharmacist, or other trained credentialed health professional (such as a certified diabetes educator)”.1
Insurance coverage for DSME/DSMS
- The Centers for Medicare and Medicaid Services (CMS) as well as many private health insurance plans provide reimbursement for both DSME and DSMS.
- DSME programs must be “recognized or accredited by a CMS-designated national accreditation organization (NAO). Current NAOs are the American Diabetes Association and the American Academy of Diabetes Educators.”
- CMS currently reimburses for, “10 program hours of initial diabetes education and 2 hours in each subsequent year.”
- Health care providers need to provide a referral for DSME. The referral must contain the following information:
- Diabetes type
- Treatment plan
- Reason for referral
When Should Diabetes Self-Management Education and Support Take Place?
The American Academy of Diabetes Educators (AADE) recommends that education and support take place at the follow critical times:1,4
- At diagnosis
- When there are new complicating factors influencing self-management
- When a transition in care occurs
What can you do?
- Ask your physician for a referral to a DSME program. You may find that you have to educate your physician on DSME, including what it is and the numerous benefits.
- To find an accredited program in your area: American Association of Diabetes Educators