Diabetes Self-Management: Pharmacist Involvement, Technology Improves Outcomes

Diabetes Self-Management Education and Support (DSMES) is increasingly important as the number of Americans who have diabetes approaches 31 million.

The National Standards for Diabetes Self Management Education and Support (the Standards) advocate for increasing these interventions. They stress that people who develop diabetes need to learn how to manage this disease to prevent or delay complications. The standards further indicate that patients need DSMES at 4 distinct time points: diagnosis, annually, when they develop complications, and at health care transitions.

The journal Diabetes Care has published a summary of current research that covers diabetes education and support and a variety of other factors that influence outcomes. The authors, a large group of academics and diabetes experts from across the country, have identified a number of current evidence-based practices and utilization trends.

The authors noted that most people who have diabetes do not receive DSMES at this time. They recommend population analysis to ensure that at-risk individuals have access to services and that clinicians understand community and regional demographics. They remind readers that appropriate population health and disease management requires interprofessional teams and ongoing social support.

Of great interest to pharmacists is the information they provide about the DSMES team. The Standards require that at least 1 team member be a registered nurse, registered dietitian or nutritionist, or pharmacist with expertise in diabetes. They stress that team members need to have specialized clinical knowledge in diabetes and behavior change principles to provide DSMES successfully. Many pharmacists are pursuing or have obtained certification in diabetes so they are well-positioned when these types of opportunities become available.

All DSMES must be individualized. The authors emphasized that individual patients need to set goals, and when they achieve those goals it's critical for health care providers to help them set new goals. At no time should they consider themselves "done."

Last, the researchers indicated that patients with diabetes must be able to select support programs that they prefer to meet their self-management needs. They noted that technologies developed to help patients with diabetes have been very successful, and many patients use texting, email, social media, web-based programs, mobile/digital/wearable/wireless devices to successfully support their goals. These programs are usually available 24 hours a day, 7 days a week.

Watch Pharmacy Times' Peer Exchange to learn more about improving collaborative care in diabetes.

Reference

Beck J, Greenwood DA, Blanton L, et al; 2017 Standards Revision Task Force. 2017 National Standards for Diabetes Self-Management Education and Support. Diabetes Educ. 2018;44(1):35-50.