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Education and support shape the future of diabetes care
As the new chair of the National Diabetes Education Program, I am excited about the opportunity to assist the NDEP in its mission to improve diabetes treatment and outcomes, promote early diagnosis, and help people prevent or delay the onset of type 2 diabetes. With more than 40 years of diabetes-related experience, I have seen tremendous advances in the field and feel optimistic about the NDEP’s efforts to further improve diabetes care and education.
Progress in diabetes management
In recent decades, we have seen significant advances in terms of diabetes medication therapies, insulin delivery options and glucose monitoring technology. Researchers and practitioners have moved the paradigm of nutrition therapy from strict dietary regimens to more flexible eating patterns. Formal diabetes self-management education is now a covered benefit through Medicare, Medicaid and most private insurers. Major clinical trials have provided evidence about the effectiveness of glycemic control for the prevention of complications, such as retinopathy, nephropathy, neuropathy, and even cardiovascular disease.
Linda Siminerio
Meanwhile, the NIH-sponsored Diabetes Prevention Program (DPP) demonstrated that type 2 diabetes could be prevented or delayed. The NDEP led an effective campaign to improve awareness among Americans that small steps can lead to big rewards when it comes to preventing or delaying this disease. The National Diabetes Prevention Program, which was modeled after the DPP, was created and continues to expand its reach in communities across the country.
Challenges for health care providers
Despite our progress, the number of Americans with diabetes and prediabetes continues to rise. More than 29 million U.S. residents — about 9% of the population — have diabetes, and another 86 million have prediabetes. One study projected the lifetime risk for a diabetes diagnosis for U.S. adults at 40%, meaning 2 in 5 American adults may be diagnosed if current trends continue.
Because diabetes is a disease almost entirely managed by the affected individual, self-management education and support to help in making behavior changes are considered gold standards. An overwhelming majority of adults with diabetes never receive diabetes education, and there simply are not enough endocrinologists to manage the diabetes population. As a result, primary care physicians, along with a broad team of health professionals, must be prepared to provide care and education to these patients.
Opportunities for care, education, support
Technology continues to change the way medical care is delivered and the way medical information is communicated. Whether sharing of information from meters or use of electronic health records, telemedicine, telephone apps and other learning tools, this exchange of information provides many opportunities to advance diabetes care, education and support.
The Affordable Care Act and the rise of patient-centered medical homes have introduced other changes in the way we provide care for chronic diseases. The NDEP’s Practice Transformation resource serves as a guide to health care professionals as they work to transform the delivery of diabetes care. One of the most promising components is the use of a team care approach. For example, professionals such as diabetes educators, nurses, dietitians, pharmacists, peer leaders and community health workers, among others, are poised to coordinate care, offload provider workloads and support patients in behavior change.
With respect to providing support for behavior change, the NDEP continues to draw attention to resources and programs that address how to make and sustain important lifestyle changes, such as increasing physical activity or coping with stress. The NDEP’s Diabetes HealthSense microsite is an online library of behavior change resources for consumers and health care professionals alike.
Improving outcomes
Incorporating team care and behavior change support into our national approach to diabetes care and education are two essential steps to improving diabetes outcomes. There are many organizations that are working to positively affect these and other aspects of diabetes. The NDEP recognizes the value of collaboration and continues to maintain its commitment to engage partners around mutually beneficial goals. Partnerships continue to bring additional opportunities to improve diabetes treatment and outcomes, promote early diagnosis, and help people prevent or delay the onset of type 2 diabetes. CDC. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: U.S. Department of Health and Human Services; 2014.
For more information:
- Gregg EW, et al. Lancet Diabetes Endocrinol. 2014;doi:10.1016/S2213-8587(14)70161-5.
- Linda Siminerio, RN, PhD, chair of the National Diabetes Education Program, can be reached at University of Pittsburgh Diabetes Institute, Falk Medical Building, Room 562, 3601 Fifth Ave., Pittsburgh, PA 1521; email: simineriol@upmc.edu.
Disclosure:
- Siminerio reports receiving research support from Becton Dickinson.