Self-management is a critical component of diabetes care and requires that patients be equipped with the proper skills and knowledge to largely manage their condition on their own. To support self-management skill development and maintenance among their patients with diabetes, primary care teams are encouraged to take advantage of opportunities before, during, and after visits; apply evidence-based strategies that enhance patient-provider communication and foster patient engagement and behavior change; and connect patients with other medical and community resources through a coordinated, planned approach. Care teams are also encouraged to routinely assess a patient’s diabetes self-management needs, skills, and interests, as well as associated factors that may serve as barriers (e.g., distress, depression, financial issues) or support mechanisms (family members, support groups, community resources). Validated assessment tools can help identify and assess changes in these factors, including diabetes-related distress,1 self-efficacy,2 self-care activities,3 and medication-taking behaviors.4
Recently, the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics published a position statement that reiterated the importance of diabetes self-management education. The position statement included an algorithm to guide primary care providers in referring patients for diabetes self-management education.5 Primary care providers are encouraged to rely on diabetes educators as members, or as an extension, of their diabetes care team who provide high-quality, standardized diabetes self-management education to patients. The services of diabetes educators can be integrated directly into the primary care setting, or practices can refer patients to an outpatient, community-based diabetes education program. Beyond the diabetes educator, primary care teams should explore ways to engage medical office staff, non-traditional practitioners, and community partners in reinforcing key messages related to optimal diabetes care and education.
The American Association of Diabetes Educators is an organization of professionals, including nurses, registered dietitian nutritionists, and pharmacists, who provide diabetes education to patients with or at risk for diabetes. To locate a Certified Diabetes Educator near you, go to Find a Diabetes Educator.
A variety of resources are available to help practices identify successful ways to integrate chronic disease self-management support techniques into their care.
- Helping Patients Manage their Chronic Conditions provides clinical strategies for providing patients with self-management support.
- Building Peer Support Programs to Manage Chronic Disease: Seven Models for Success describes seven peer support models: professional-led group visits, peer-led self-management training, peer coaches, community health workers, support groups, telephone-base peer support, and web- and email-based programs. Case studies are offered to demonstrate how individual models have been put into practice. Cost and reimbursement information is also provided.
- Diabetes Planned Visit Notebook provides tools and lessons for teaching medical residents and improving care for patients with chronic illnesses.
- Improving Chronic Illness: Planned Care Visit: The Self-Management Interview demonstrates key components of a self-management interview as part of a planned care visit.