The Four Key Times to See a Diabetes Educator

Twitter Summary: Why is #diabetes education SO critical? Major orgs come together for joint position statement on #DSMES. Plus, how to find an educator near you!

Last month, several major organizations (ADA, AADE, and AND) released a joint position paper on Diabetes Self-Management Education and Support, abbreviated DSMES. This publication for the first time lays out a process for when and how people with type 2 diabetes should receive DSMES (while the paper focused on type 2 diabetes, the authors note that similar recommendations hold true for type 1). According to the paper, people with diabetes should be referred for DSMES, which may be delivered by a Certified Diabetes Educator (CDE) or healthcare provider working with the CDE, at four key stages: diagnosis, annual assessments, when new complicating factors arise (e.g., new health conditions, the onset of a diabetes-related complication), or when there are transitions in care (e.g., moving to a new city, switching health care providers, etc.).

Increasing the number of people who obtain DSMES is a critical issue. According to a 2014 CDC/AADE analysis of health claims from people with private health plans and newly diagnosed type 2 diabetes, less than 7% of patients were ever referred for DSMES, though 83% of those who are referred end up participating in diabetes education programs.

What do diabetes educators do? Diabetes educators aim to collaborate with the full health care team to help people develop personalized strategies to manage their diabetes, incorporating many factors from medications, lifestyle, eating habits, etc. into a cohesive plan they are able to follow. In addition to teaching the skills and behaviors to help them manage diabetes – how to dose insulin, what foods to eat and how much – diabetes educators strive to get to know patients on a personal level, appreciating the cultural and social influences that may impact someone’s diabetes management. As Past President of AADE Joan Bardsley (MBA, RN, CDE) said at ADA this year, “A key piece [of diabetes education] is not just teaching diet and glucose monitoring; it’s assessing the patient, who they are, and where they’re coming from.” Diabetes educators, through delivery of DSMES, also hope to provide ongoing and constantly evolving support.

Excitingly, there was a lot of news from the recent ADA Conference in June surrounding the benefits of diabetes education. Martha Funnell (MS, RN), a co-author of the position paper, stressed that diabetes education and improvement in patient decision-making can lead to better blood glucose control, higher quality of life, fewer complications, and reduced costs from hospitalizations. Indeed, diabetes education has been shown to lower A1c by as much as 1% in type 2 diabetes. Ms. Bardsley also stressed that DSMES is reimbursable benefit under Medicare, covering ten hours in the first year of diagnosis in addition to covering another Medicare benefit: Medical Nutrition Therapy. Again, awareness is the key issue – as many people are not aware that diabetes education can be covered by insurance.

As our Editor-in-Chief Kelly Close outlined in her reflections of this past ADA Conference, the diabetes community needs to invest more resources into tools and programs that help people make critical behavior changes in diabetes. Diabetes education is a crucial and exceedingly cost-effective tool in the diabetes arsenal, and it is encouraging to see increasingly more focus on the benefits of DSMES. This position statement provides a very clear pathway for referrals for DSMES, and the challenge now is to raise awareness amongst primary care providers on how to use it.

If you or someone you know is interested in finding a diabetes educator, check out these links to find ADA and AADE programs with diabetes educators and that are covered by health plans and Medicare. Additionally, you can use AADE’s “Find a Diabetes Educator” tool here and talk to your health care provider about receiving a referral for diabetes education. Also consider checking out these awesome infographic “Tip Sheets and Handouts" from AADE. -AJW