The Benefits of Diabetes Self-Management Education

Diabetes mellitus is a chronic disease characterized by high glucose levels (hyperglycemia) due to metabolic disorders that prevent patients from producing sufficient amounts of insulin. Globally, there are various pillars of diabetes mellitus management, and one of the most important pillars for prevention and management is education. When properly carried out, it provides benefits to people with diabetes mellitus. Diabetes self-management education (DSME) plays a key role in empowering people with diabetes to engage and sustain lifestyle changes, which have been shown to improve health outcomes. This article explores the effectiveness and benefits of diabetes self-management education.

Understanding Diabetes Mellitus

Diabetes mellitus (DM) is a chronic disease characterized by high glucose levels (hyperglycemia) due to metabolic disorders that prevent the patient from producing sufficient amounts of insulin. The disease can be prevented and controlled by engaging in certain behaviors and lifestyles such as regular exercise, healthy eating patterns, avoiding smoking, and controlling fat and glucose in the blood.

The World Health Organization stated that the number of people living with diabetes mellitus (DM) worldwide reached 422 million, and every year 1.6 million deaths are recorded. The prevalence of the disease in the world is estimated to reach 642 million people by 2040. In 2019, the countries with the highest number of DM sufferers were China, India, the United States, Pakistan, Brazil, Mexico, and Indonesia, with an estimated number of 10 million patients. The number of people living with diabetes could be much greater than the prevalence described, because most sufferers only seek medical help after complications occur.

The rising prevalence of diabetes mellitus is due to several factors, such as unhealthy behavior. This behavior is still rampart in Indonesian society, and is evidenced by the results of the Basic Health Research 2018, where 13.6% of the residents were overweight, 21.8% had obesity, and 31% central obesity. Other unhealthy habits include the use of tobacco by men (62.9%) and smoking by adolescents (10-18 years) (23.91%).

The Role of Diabetes Self-Management Education (DSME)

DSME is the process of facilitating the knowledge, attitudes, and abilities necessary for self-management. In addition to this, DSME play an important role in influencing the self-care practices of patients with diabetes mellitus. Furthermore, the Association of Diabetes Care and Education (AADE) has guidelines for diabetes self-management education (DSME). In reality, there are many health workers that provide education without paying attention to these guidelines.

There are seven major behaviors related to diabetes self-care management, they include diet, physical activity, monitoring blood glucose levels, adherence to proper medication consumption, good problem solving, coping skills, and risk reduction behavior. Continuous selfcare will reduce the incidence of DM complications. DM management focuses on several aspects, namely education, meal planning, changes in lifestyle, physical activity, habits. One study explained that educational interventions influence knowledge, physical activity, food intake, self-efficacy, and health literacy.

Impact on Lifestyle Changes

Several interventions are also able to influence lifestyle changes such as increasing the duration of exercises (cycling, walking, aerobics), reducing smoking habits, and increasing the consumption of fruits and vegetables. Lifestyle changes caused by DSME interventions are expected to improve the clinical and health status of T2DM patients.

DSMES has a positive impact on lifestyle changes, such as eating patterns and activity levels. Diabetes is complicated, and it takes practice to manage it in your everyday life. You may be wondering about eating balanced meals, exercising safely, checking blood sugar, or giving yourself injectable medicines.

Clinical and Health Status Improvements

One study proved this showing DSME’s effectiveness in controlling fasting blood glucose, random blood glucose, total cholesterol, and triglycerides. In line with that, other studies also showed that DSME can influence glycemic control, body weight and BMI control.

DSME has a positive effect on T2DM patients to improve their knowledge, behavior, self-efficacy, and clinical conditions of patients such as blood glucose levels, HbA1c, lipid profiles. DSME helps you manage diabetes so you can prevent or delay serious diabetes complications like heart disease, kidney disease, amputations, and vision loss. People who participate in DSMES are more likely to have better overall health and improved quality of life with diabetes.

Read also: Better Health Outcomes

HbA1c Levels and DSME

Apart from data homogeneity in the article, another difference was found regarding the effect of DSME on HbA1c. Cunningham states that DSME does not significantly affect HbA1c. This is in contrast with other studies which explain that this intervention can significantly affect HbA1c. The difference that lies in the presence or absence of this effect on HbA1c can be a concern in future studies to consider the determining factors that can influence it.

Access and Availability of DSMES

Despite the evidence, use of DSMES services is low. Less the 5% of Medicare beneficiares with diabetes and 6.8% of privately insured people with diabetes have participated in DSMES within the first year of diagnosis. As of 2020, a total of 2,158 sites were delivering DSMES services across the United States. Every year, nearly 1 million people with diabetes receive DSMES services recognized or accredited by ADA or ADCES. However, there are gaps in availability.

Organizations offering DSMES can apply for recognition by the American Diabetes Association (ADA) or accreditation by the Association of Diabetes Care & Education Specialists (ADCES). These organizations are eligible for reimbursement by Medicare, many private health plans, and some state Medicaid agencies. Medicare Part B beneficiaries with diabetes are eligible for 10 hours of diabetes education over the course of a year. They must receive a referral from their physician, nurse practitioner, clinical nurse specialist, or physician assistant. People with diabetes are then eligible to receive 2 hours of additional diabetes education in each subsequent year.

The Financial Impact of Diabetes and the Benefits of DSMES

Diabetes is the seventh leading cause of death in the United States, and people with diagnosed diabetes have a higher risk of early death than those without diabetes. Diabetes is also associated with increased risk for some types of cancer, including liver, pancreas, colon, breast, and bladder.

The financial burden of diabetes is substantial-billions annually due to increased medical costs and lost productivity. People with diagnosed diabetes have on average medical costs that are 2.6 times as much as those without diabetes. Fortunately, DSMES, which is an evidence-based service, can help people with diabetes live longer and healthier lives. DSMES can help you improve your blood sugar levels to prevent or delay complications, avoid emergency care, and save you money on health care costs.

Read also: Managing Diabetes with NovoCare

Practical Steps for Individuals with Diabetes

Participating in DSMES is linked to positive changes in health behaviors and improved diabetes-related outcomes. Ask your doctor to recommend a diabetes educator. Ask your doctor for a referral to DSMES to get started. Insurance coverage of DSMES varies, but many plans cover diabetes education. Medicare covers up to 10 hours of DSMES if you've been diagnosed in the past year. After the first year, your coverage may change. Note that Medicare refers to DSMES as diabetes self-management training (DSMT).

Types of Diabetes

Diabetes is a chronic (long-lasting) condition where the body struggles to manage appropriate levels of blood sugar (glucose) and insulin, the hormone that controls blood sugar. The three main types of diabetes include type 1, type 2, and gestational diabetes (while pregnant). Type 1 diabetes is an autoimmune condition where the pancreas no longer creates enough insulin. Type 2 diabetes involves insulin resistance where the body can no longer use the insulin available in blood, this type of diabetes can often be prevented and treated with lifestyle changes. Lifestyle changes with or without the use of medication are effective for treating diabetes, there is currently no cure. These services help people with diabetes learn how to take the best care of themselves through knowledge building, self-management skills, and empowerment. DSMES is provided by a healthcare team specialized in diabetes management who often have a personal connection to diabetes as well.

Diabetes and Kidney Health

Individuals who have diabetes and high blood pressure are at a higher risk of having chronic kidney disease (CKD). If someone has CKD, their kidneys are not able to filter out toxins and waste from their blood. Diabetes is a leading cause of CKD. However, both conditions can be prevented and treated with lifestyle changes. Check blood pressure regularly, if this is elevated speak with your doctor about treatment options.

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