2014 National Diabetes Survey: Lessons Learned

Nurse-managed protocols improved outpatient care in chronic illnesses
Nurse-managed protocols improved outpatient care in chronic illnesses
Results highlight importance of addressing psychological issues, behavior change strategies and more.

NEW ORLEANS — A multidisciplinary team, behavior change strategies and diabetes self-management education (DSME) are integral to helping a person with diabetes manage the disease and delay or prevent complications, according to two experts.

“If patients believe their physicians think diabetes education is important, they take it a lot more seriously. Patients trust their providers,” said Linda Siminerio, RN, PhD, CDE, who is the executive director of the University of Pittsburgh Diabetes Institute.

Siminerio and her colleagues have been studying the results from the 2014 National Diabetes Education Program (NDEP) National Diabetes Survey and shared some key findings from the survey on the implications for clinicians, health care teams and their practices at AADE 2015, the annual meeting of the American Association of Diabetes Educators.

“With the increased number of people at risk for type 2 diabetes and patients being diagnosed with diabetes, creative strategies need to be developed that can help patients meet their goals and lower their risk of diabetes complications. Health care teams need to work together to overcome the myriad challenges, such as access to diabetes education and support, lack of reimbursement, minimal training in handling psychosocial needs and limited time with patients,” Siminerio told Endocrinology Advisor.

The 2014 National Diabetes Survey findings are a good yardstick for assessing trends in awareness, knowledge and attitudes about diabetes prevention, control and self-management behaviors, according to Siminerio.

The survey is also helpful because it includes data from high-risk racial and ethnic populations. The survey is population-based and conducted every few years.  The first one was conducted in 2006. Subsequent surveys were completed in 2008, 2011 and 2014.

Approximately 2,000 adults aged 35 years and older were surveyed, including Hispanic and African American adults. The 2014 survey measured the public’s knowledge, attitudes and practices related to diabetes prevention and diabetes self-management and highlights how attitudes and practices have changed over the past 8 years.

“A team-based approach to diabetes care is an effective way to help people with diabetes manage the disease, prevent and treat complications, provide behavior-change strategies and cope with the emotional challenges this chronic disease brings,” said Siminerio. “When providers refer patients to diabetes education, we see an 83% participation rate, but without those referrals, participation is abysmally low.”

She said DSME and support improve diabetes outcomes, including reducing HbA1c levels. If clinicians employ a comprehensive team approach, it is possible to reduce onset and advancement of diabetes complications and improve lifestyle behaviors.

Siminerio also noted that self-management education can help patients to follow healthy lifestyle behaviors, such as following a more healthful diet and exercising more frequently.

One major concern that must be addressed by clinicians and their teams relates to psychosocial issues, according to the survey. Psychological treatment and therapies can help improve diabetes self-management and improve quality of life. Conversely, comorbid depression has been associated with impaired self-management. 

“It is important to decrease diabetes-related distress and depression. Studies have also shown education to be cost effective by reducing hospital admissions and readmissions,” said Siminerio.


  1. Siminerio L, Gallivan J. F09 – Results from the 2014 NDEP National Diabetes Survey and Implications for Practice. Presented at: AADE 2015; Aug. 5-8, 2015; New Orleans.