Diabetes
is a complex and challenging disease that requires daily self-management
decisions made by the person with diabetes. Diabetes self-management education
and support (DSMES) addresses the comprehensive blend of clinical, educational,
psychosocial, and behavioral aspects of care needed for daily self-management
and provides the foundation to help all people with diabetes navigate
their daily self-care with confidence and improved outcomes (1,2).
<p>The
prevalence of diagnosed diabetes is projected to increase in the U.S from 22.3
million (9.1% of total population) in 2014, to 39.7 million (13%) in 2030, and
to 60.6 million (17%) in 2060 (3). Approximately 90-95% of those with
diabetes have type 2 diabetes (4). Diabetes is an expensive disease, and the medical costs of health care alone for
a person with diabetes are 2.3 times more than for a person without diabetes (5). Confounding the diabetes epidemic
and high costs, therapeutic targets are not being met (6). There is a lack of improvement in
reaching clinical target goals since 2005 despite advancements in medication
and technology treatment modalities. Indeed, between 2010 and 2016 improved outcomes
stalled or reversed (6).</p>
<p>The
goals of the consensus report are to improve clinical care and education
services, to improve the health of individuals and populations, and to reduce
diabetes-associated per capita health care costs (1,7). This paper is specifically directed
towards health care providers (physicians, nurse practitioners, PAs), referred
to herein as providers, as it outlines the benefits of DSMES; defines 4
critical times to provide and modify DSMES (see Figure 1); proposes how to
locate DSMES related resources; and discusses potential solutions to access and
utilization barriers. This report provides guidance to others as well: health
systems and organizations can use this report to anticipate and address the
needs of persons with diabetes and create access to DSMES services; persons
with diabetes can increase their awareness of DSMES services as part of quality
care and can advocate for self-management education and support; and payers and
policy makers can work to design reimbursement processes that support
participation in DSMES. The consensus report’s recommendations are listed in
Table 1.</p>
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
