Diabetes Education: We Can Do Better

Lifestyle management has been the cornerstone of diabetes treatment since the disease was first identified. Insulin and medications are actually relative newcomers to the options available for treatment. Every major diabetes organization recommends diabetes self-management education and support (DSMES) is part of standard care for all individuals with diabetes.

The benefits of DSMES are many including:

• Improved clinical outcomes (specifically reduced A1C, weight and all-cause mortality risk)
• Reduced healthcare costs
• Improved diabetes knowledge and self-care behaviors
• Improved quality of life

Yet, this essential element of treatment is not reaching patients. Recent data shows alarming facts:

• Only 5% of Medicare beneficiaries with newly diagnosed diabetes used DSMES services. (1)
• Only 6.8% of individuals with type 2 diabetes and private health insurance received DSMES services within the first year of diagnosis. (2)

This low participation is due to many factors including low levels of physician referrals to education, inconvenient times and access issues, concerns about costs and more. While many efforts are in place to improve these numbers for diabetes services offered in traditional settings (hospital clinics, outpatient medical offices), even greater attention is being given to ways to make diabetes education available whenever and wherever the patient needs it… which means using technology to assist.

Not only is technology-enabled education convenient for patients – it works. (3) Research shows the benefits and outcomes are greater when there is two-way communication between the patient and the healthcare team, when there is individualized feedback and includes the use of patient-generated health data and education to customize the messages.

In my own experience interacting with people with type 2 diabetes participating in a moderated Facebook community (Diabetes What to Know), I’ve been impressed by the ways that peers help each other. For example,

• A woman worried about what to do when she sees her morning blood glucose levels consistently above target is guided to watch a short video on hyperglycemia while she awaits her appointment with her doctor.
• A man wondering what to eat for a snack when he goes out for a round of golf is offered suggestions as well as a handout he can print.
• A middle aged woman learning she has to start on insulin turns to the community for support and is flooded with encouraging words of support by people who’ve followed a similar path.

Technology-enabled diabetes education provides access to much needed just-in-time resources and information. It also includes the opportunity for personalizing messages to patients, working collaboratively to help them problem-solve and become more confident diabetes self-managers. As you look for web-based education services you can trust, look for those that include the input and participation of respected diabetes medical care providers, registered dietitians and certified diabetes educators.

References

• Strawbridge. Health Edu Behav. (2015);
• Li. MMWR Morb Mortal Wkly Rep. (2014)
• Greenwood DA et al. J Diabetes Sci Technol (2017)
  Author Information:

Melinda is a consultant in Diabetes & Nutrition and resides in Boston, MA. After working in traditional diabetes care settings for over 35 years, Melinda now spends much of her time working with online diabetes communities, including Diabetes What to Know. She is one of the co-authors of both the 2017 National Standards of Diabetes Self-Management Education and Support and the 2017 American Diabetes Association’s Standards of Medical Care.