As a practicing diabetes educator for the past 15 years, the author has learned that there are a variety of reasons why DSME/T is not a universal intervention for those with diabetes. Many providers do not realize that education services are now reimbursed by Medicare and many health plans. Often, providers are not aware of the diabetes education resources within their own community. Some reserve a referral to education for those patients for whom nothing else has worked to control their diabetes (the proverbial ‘train wrecks’).
As a practicing diabetes educator for the past 15 years, the author has learned that there are a variety of reasons why DSME/T is not a universal intervention for those with diabetes. Many providers do not realize that education services are now reimbursed by Medicare and many health plans. Often, providers are not aware of the diabetes education resources within their own community. Some reserve a referral to education for those patients for whom nothing else has worked to control their diabetes (the proverbial ‘train wrecks’). Other providers operate under the cynical belief that patients are not likely to change their behaviors to improve their diabetes control, even if they do receive education. This article seeks to expound on the relationship between DSME/T and behavior changes, and how the outcomes of diabetes education can be systematically measured to demonstrate its effectiveness in the treatment of individual patients. A review of the literature shows that diabetes education has merit. A metaanalys s by Norris of 72 studies performed over nearly 20 years showed that diabetes education is an effective intervention for patients with type 2 diabetes but that its benefits are short-lived (about six months).6 This reinforces the idea that DSME/T should not be a one-time event, as people need reinforcement of learned behaviors in order to sustain them over time. More research is needed to look into interventions that sustain behavior change.
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