A consensus statement published in Diabetes Care outlines the benefits and barriers associated with diabetes self-management education and support (DSMES) in adults with type 2 diabetes.
Recognized as one of the core elements of comprehensive diabetes care, DSMES provides a foundation to strengthen the knowledge and skills of patients with diabetes and empower them to manage their disease with confidence. Studies have shown that DSMES may improve clinical, psychosocial, and behavioral outcomes.
The current consensus report of the American Diabetes Association, the Association of Diabetes Care and Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association is intended for healthcare providers.
According to the 2017 National Standards for Diabetes Self-Management Education and Support, DSMES is defined as “[t]he ongoing process of facilitating the knowledge, skills, and ability necessary for diabetes self-management as well as activities that assist a person in implementing and sustaining the behaviors needed to manage his or her condition on an ongoing basis, beyond or outside of formal self-management training. This process incorporates the needs, goals, and life experiences of the person with diabetes.”
There are various DSMES approaches and settings that can be offered and adjusted according to the specific needs of each patient. While in the past DSMES services were offered in the form of didactic classes in the hospital or a healthcare facility, nowadays DSMES services can be incorporated into many settings, including community health centers, pharmacies, faith-based organizations, and home settings.
It is recommended that providers discuss the benefits and importance of DSMES with all patients with diabetes and support the use of DSMES services at critical times, including diagnosis, annually and/or when treatment targets are not met, when complicating factors arise, and during transitions in life.
There are no downsides to DSMES but the potential benefits are numerous, including the option to guide and support patients in implementing treatment plans, avoidance of hospital admissions or visits to the emergency department, improvement of glycemic control and weight management, prevention of hypoglycemia, enhanced self-confidence and self-efficacy, improvement in quality of life, and reduction in all-cause mortality. Furthermore, most insurers, including Medicare, cover the costs of this modality.
It is important to identify and manage potential barriers to DSMES, including health system barriers (eg, a limited number of specialists or access to services), provider-related barriers (eg, lack of awareness of DSMES services), participant-related barriers (eg, cost issues or medical status), and environmental barriers (eg, limited transportation services or social conditions).
DSMES can provide the foundation, as well as the ongoing support, necessary to help patients overcome barriers to optimal care. It is vital to adjust and modify DSMES according to the patient’s changing needs throughout the continuum of diabetes treatment and life transitions. Increasing awareness and access and addressing barriers and changes in reimbursement policies are important steps to take to increase uptake of DSMES services.
Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
Powers MA, Bardsley JK, Cypress M, et al. Diabetes self-management education and support in adults with type 2 diabetes: a consensus report of the American Diabetes Association, the Association of Diabetes Care and Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association [published online June 8, 2020]. Diabetes Care. doi:10.2337/dci20-0023