The power of taking a personalized approach to diabetes self-management
Treatment plans that incorporate collaborative, person-first support and education have been shown to improve the health outcomes of people with diabetes
Diabetes is a nationwide epidemic, according to the American Diabetes Association (ADA). In 2019, roughly 11.3% of Americans — 37.3 million people — had been diagnosed with diabetes, 8.5 million were considered undiagnosed, and 96 million more were considered prediabetic1.
The medical costs of people with diabetes are estimated to be 2.3 times higher compared to those without diabetes2. Further, indirect costs of this widespread disease to the US economy range from reduced productivity and increased absenteeism at work and in life to the inability to work at all.
A recent report from the ADA, “Standards of Care in Diabetes—2023,” proves that empowering people with diabetes through diabetes self-management education and support (DSMES) could improve their health outcomes3. The creation and implementation of collaborative, person-centered treatment plans lies at the heart of this approach.
Knowledge is power
The needs, goals and life experiences of people with diabetes differ from person to person. Incorporating personal input into DSMES plans can support overall treatment, as well as improve an individual’s overall wellbeing.
According to the ADA, the inclusion of DSMES into individual treatment plans can result in improved self-care behaviors and quality of life, positive coping behaviors, lower weight, reduced A1C — a hemoglobin chemically linked to sugar — reduced risk of mortality, and reduced healthcare costs3.
Furthermore, DSMES interventions that accounted for age, culture, individual needs and preferences, psychosocial factors and behavioral strategies were among the most successful cases. The longer a person participates in a DSMES-oriented treatment plan, the better the outcome. For example, the ADA claims people who were exposed to more than 10 hours of DSMES over the course of six to 12 months saw particularly improved health outcomes3.
There are four major instances in which the need for DSMES should be considered as part of a patient’s treatment plan, according to the ADA: at diagnosis; annually, or when not meeting treatment targets; when mental, physical and psychosocial complications develop; or when life or care changes occur.
A successful DSMES program should include the following:
- Medical nutrition therapy
- Physical activity
- Smoking cessation
- Supporting positive health behaviors
- Psychosocial care
Medical nutrition therapy
“For many individuals with diabetes, the most challenging part of the treatment plan is determining what to eat,” the ADA stated. As with most things, there is no silver bullet approach to diabetic nutrition. However, medical nutrition therapy can play a key role in managing diabetes on an individualized level. This includes setting personalized nutrition goals to achieve ideal body weight and health metrics, as well as to prevent complications of the disease.
Medical nutrition therapy should also place emphasis on weight management. The ADA cited strong evidence that moderate, consistent weight loss can not only slow progression from prediabetes to type 2 diabetes but can also be an effective management tool for people with type 2 diabetes.
Physical activity
Exercise is a subset of physical activity, but both are important when it comes to diabetes self-care and management. According to the ADA, regular exercise can contribute to weight loss, boost blood glucose levels, reduce cardiovascular complications, and improve overall wellbeing.
Smoking cessation
There is a causal link between tobacco products, including cigarettes, e-cigarettes and others, and health risks. This is old news but remains a particularly important consideration for people with diabetes.
Additionally, the recent growth in popularity and accessibility of e-cigarettes poses an increased risk for adults and adolescents with or at risk of diabetes, whether used in place of cigarettes and other tobacco products, as a tool for cessation, or recreationally. Education is a powerful tool that can be used by DSMES practitioners to systematically engage these individuals to quit tobacco.
Supporting positive health behaviors
Health-promoting behaviors can help people with diabetes, as well as their caregivers and family members, internalize self-care and better cope with the disease. These behaviors include monitoring blood glucose levels, taking medicine and insulin, engaging in physical activity, making nutritional adjustments, and utilizing available technology to improve health outcomes.
Motivational interviewing, goal setting and action planning, problem solving, social support, encouraging self-monitoring, and other tactics can be used by DSMES practitioners to support positive health behaviors. The ADA suggests using “multicomponent intervention packages” (i.e., employing several strategies for promoting positive health behaviors) can result in more efficacious outcomes for both behavioral and glycemic health outcomes.
Psychosocial care
Diabetes care can feel like an unrelenting, Herculean effort, and can take a significant toll on affected individuals as well as their families and caretakers. For example, studies have shown people with diabetes are two to three times more likely to have depression than people without diabetes4.
Addressing the mental and emotional wellbeing of people with diabetes is a crucial aspect of treatment, especially when it comes to DSMES, as untreated psychosocial implications can impact a person’s ability to effectively carry out diabetes self-care and management.
These five pillars of a well-rounded DSMES approach are inextricably linked by one thing: wellbeing. Physical health is intimately related to mental, emotional and psychosocial health. Therefore, treatment plans and supportive resources for people with diabetes must take all aspects into account.
As the old adage goes, “Give a man a fish and you feed him for a day. Teach a man to fish and you feed him for a lifetime.” Offering people with diabetes modern, holistic approaches — like DSMES — represents the next step in empowering individuals to play a more active role in their treatment plans and, in a way, take their health and wellbeing into their own hands.
WellSpark’s Diabetes Self-Management Education and Support program (DSMES) can help those affected by diabetes to better manage their disease process, avoid complications, achieve optimal health outcomes and reduce disease distress. The quality of WellSpark’s accredited DSMES program has been audited and verified by the Association of Diabetes Care and Education Specialists (ADCES). Learn more about WellSpark’s customized support for anyone living with diabetes by following this link: https://www.wellsparkhealth.com/solution/help-364/
Sources:
[1] Centers for Disease Control and Prevention. National Diabetes Statistics Report website. https://www.cdc.gov/diabetes/data/statistics-report/index.html. Accessed Oct. 2, 2023.
[2] American Diabetes Association. “The Cost of Diabetes.” https://diabetes.org/about-us/statistics/cost-diabetes. Accessed Oct. 2, 2023.
[3] American Diabetes Association. Diabetes Care, December 2022, Vol. 46, S68-S96. “Standard of Care in Diabetes – 2023.”https://diabetesjournals.org/care/issue/46/Supplement_1. Accessed Oct. 2, 2023.
[4] Center for Disease Control and Prevention. “Diabetes and Mental Health.” https://www.cdc.gov/diabetes/managing/mental-health.html Accessed Oct. 2, 2023.