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PDF By the most recent estimates, At the same time, 79 million people are estimated to have blood glucose levels in the range of prediabetes or categories of increased risk for diabetes. Thus, more than million Americans are at risk for developing the devastating complications of diabetes 1.
Diabetes self-management education DSME is a critical element of care for all people with diabetes and those at risk for developing the disease. It is necessary in order to prevent or delay the complications of diabetes 2 — 6 and has elements related to lifestyle changes that are also essential for individuals with prediabetes as part of efforts to prevent the disease 78.
The National Standards for Diabetes Self-Management Education are designed to define quality DSME and support and to assist diabetes educators in providing evidence-based education and self-management support. The Standards are applicable to educators in solo practice as well as those in large multicenter programs—and everyone in between.
There are many good models for the provision of diabetes education and support. The Standards do not endorse any one approach, but rather seek to delineate the commonalities among effective and excellent self-management education strategies.
These are the standards used in the field for recognition and accreditation. They also serve as a guide for nonaccredited and nonrecognized providers and programs. Because of the dynamic nature of health care and diabetes-related research, the Standards are reviewed and revised approximately every 5 years by key stakeholders and experts within the diabetes education community.
Members of the Task Force included experts from the areas of public health, underserved populations including rural primary care and other rural health services, individual practices, large urban specialty practices, and urban hospitals.
They also included individuals with diabetes, diabetes researchers, certified diabetes educators, registered nurses, registered dietitians, physicians, pharmacists, and a psychologist.
The Task Force was charged with reviewing the current National Standards for Diabetes Self-Management Education for their appropriateness, relevance, and scientific basis and updating them based on the available evidence and expert consensus.
This name change is intended to codify the significance of ongoing support for people with diabetes and those at risk for developing the disease, particularly to encourage behavior change, the maintenance of healthy diabetes-related behaviors, and to address psychosocial concerns.
Currently, there are significant barriers to the provision of education and support to those with prediabetes. And yet, the strategies for supporting successful behavior change and the healthy behaviors recommended for people with prediabetes are largely identical to those for individuals with diabetes.
As barriers to care are overcome, providers of DSME and diabetes self-management support DSMSgiven their training and experience, are particularly well equipped to assist individuals with prediabetes in developing and maintaining behaviors that can prevent or delay the onset of diabetes.
Many people with diabetes have or are at risk for developing comorbidities, including both diabetes-related complications and conditions e. In addition, the diagnosis, progression, and daily work of managing the disease can take a major emotional toll on people with diabetes that makes self-care even more difficult 9.
In the course of its work on the Standards, the Task Force identified areas in which there is currently an insufficient amount of research. In particular, there are three areas in which the Task Force recommends additional research: What is the impact of using a structured curriculum in DSME?
What training should be required for those community, lay, or peer workers without training in health or diabetes who are to participate in the provision of DSME and to provide DSMS?
Finally, the Standards emphasize that the person with diabetes is at the center of the entire diabetes education and support process. It is the individuals with diabetes who do the hard work of managing their condition, day in and day out.
The ongoing process of facilitating the knowledge, skill, and ability necessary for prediabetes and diabetes self-care. This process incorporates the needs, goals, and life experiences of the person with diabetes or prediabetes 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.
Activities that assist the person with prediabetes or diabetes 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.
The type of support provided can be behavioral, educational, psychosocial, or clinical 11 — For those providers working within a larger organization, that organization will recognize and support quality DSME as an integral component of diabetes care. In the business literature, case studies and case report investigations of successful management strategies emphasize the importance of clear goals and objectives, defined relationships and roles, and managerial support.
Business and health policy experts and organizations emphasize written commitments, policies, support, and the importance of outcomes reporting to maintain ongoing support or commitment 16 Documentation of an organizational structure that delineates channels of communication and represents institutional commitment to the educational entity is critical for success.
According to The Joint Commission, this type of documentation is equally important for both small and large health care organizations Health care and business experts overwhelmingly agree that documentation of the process of providing services is a critical factor in clear communication and provides a solid basis from which to deliver quality diabetes education.
Often, but not always, this external input is best achieved by the establishment of a formal advisory board. The result is effective, dynamic DSME that is patient centered, more responsive to consumer-identified needs and the needs of the community, more culturally relevant, and more appealing to consumers 1719 Currently, the majority of people with diabetes and prediabetes do not receive any structured diabetes education 19 While there are many barriers to DSME, one crucial issue is access Sheet3 Libarary CCaldwell EThePageant GG The Bender Family Lineage Burnham May Cooper Abel and Polly Manny Cooper; Fielding and Sarah Hunt:Their Ancestors.
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