Paradigm Shift: Symptom Management vs Preventative Care in Diabetes Mellites

Symptom Management Perspective

Preventative Care Perspective

Pathogenic View-Disease Oriented 19th Century-Clinic and Hospital Surveillance Prognostic sign-what will happen Anamnestic sign-what has happened Diagnostic sign-what is taking place now  Patients views and opinions set aside. Responsibility was on MD exclusively. Body and Mind Separate

Salutogenic View-Health Oriented Focus-producing theories of health based on more holistic approaches and methods. Well-being rather than disease pathogenesis. Positive Health-predictability, sense of having control over one’s own affairs and value or importance attached to things or other people. – active or rich life experiences by oneself. Life-Course Perspective-focus on different stages of life. Different life conditions (housing, nutrition, access to education or healthcare) impact health later in life. Includes Social Capital developed over the life span. Health as Adaptedness-As people age, they compensate for problems

Common Complications in Diabetes Patients

Shifting to Prevention

Building a Diabetes Self-Management Education and Support Program Center for Disease Control and Prevention (CDC)

DSMES Toolkit

Preventative Care in Diabetes Mellites in both Type 1 & Type 2 is essential in supporting the long-term health of individuals living with diabetes.

The CDC has an excellent toolkit to help providers and diabetes educators to create an evidenced based patient and care partner self-management and support program to improve individuals’ ability to work on individual prevention of complications related to diabetes.

From the CDC DSMES Toolkit Website: DSMES has been shown to improve health outcomes.

In the United States, less than 5% of Medicare beneficiaries with diabetes and 6.8% of privately insured people with diagnosed diabetes have used DSMES services. (Strawbridge LM, et al. 2015)

The purpose of this toolkit is to increase use of DSMES services among people with diabetes and promote healthcare provider referrals. Expanded use of DSMES can help ensure that all people with diabetes receive the support they need. The toolkit provides resources and tools in one place to assist with the development, promotion, implementation, and sustainability of DSMES services (Strawbridge LM, et al. 2015)

What to Include in a Diabetes Self-Management Education and Support Program General information about diabetes Pathophysiology Medications Use of devices Insulin Pump Blood Glucose Monitoring Tools- Continuous Glucose Monitor Insulin Pens Diabetes Management Apps Lifestyle Nutrition Exercise/Movement Mindfulness Meal Preparations Support Medical Family/Care partners Prevention of Complications

Diabetes Education Program at the University of Utah

Inclusion of Family and Care partner support in Diabetes Self-Management Education and Support Programs

Intensive Diabetes Education and Support (IDEAS)

Diabetes Self-Management Education and Support Programs (DSMES) are designed for both patients and their care partners. Demographics of those who attended two different DSMES programs in 2019-2021 was examined. Surprisingly, attendance of a care partner was higher in the eight-hour program than in the 4-hour program. Understanding the reasons for the difference in care partner attendance is important to review in the future.

Family and Care partner Support

References

Centers for Disease Control and Prevention. (2021, August 10). Diabetes self-management education and support (DSMES) toolkit . Centers for Disease Control and Prevention. Retrieved April 26, 2022, from https://www.cdc.gov/diabetes/dsmes-toolkit/index.html

Strawbridge LM, Lloyd JT, Meadow A, Riley GF, Howell BL. Use of Medicare’s Diabetes Self- Management Training Benefit. Health Educ Behav. 2015;42(4):530-538.

Strawbridge LM, Lloyd JT, Meadow A, Riley GF, Howell BL. One-Year Outcomes of Diabetes Self- Management Training Among Medicare Beneficiaries Newly Diagnosed With

Diabetes. Med Care. 2017;55(4):391-397..