Self-management education for the child with diabetes mellitus
- Barbara Schreiner, PhD, RN, CDE, BC-ADM
Barbara Schreiner, PhD, RN, CDE, BC-ADM
- Nursing Faculty
- Capella University
- Stephen Ponder, MD, FAAP, CDE
Stephen Ponder, MD, FAAP, CDE
- Professor of Pediatrics
- Texas A&M University College of Medicine
Diabetes is an unrelenting chronic illness requiring management by skilled professionals, and daily attention and action by the child and parent. Diabetes self-management education and support (DSME/S) provides the framework and information for preparing a family to take responsibility for the child's diabetes care, and facilitates the transition to self-care as the child matures. DSME/S is an integral component of care for all patients with diabetes [1,2].
The curriculum, educational principles, and outcomes of DSME/S are outlined in this topic review. DSME/S should be closely coordinated with diabetes medical care, which is described separately. (See "Management of type 1 diabetes mellitus in children and adolescents".)
US NATIONAL STANDARDS
In 1986, the National Diabetes Advisory Board, the American Diabetes Association (ADA), and other professional organizations articulated initial standards of practice for diabetes education programs in the United States. In 2007, revised national standards for diabetes self-management education (DSME) were published that more fully incorporated the needs of diverse patient care settings . Since 2011, the American Diabetes Association has included DSME in its revised version of Standards of Medical Care in Diabetes and recommends that all people with diabetes receive DSME at diagnosis and as needed thereafter . In 2012, the national task force added diabetes self-management support (DSMS) to the national standards, reflecting the need for ongoing maintenance of healthy behaviors .
The national standards provide patients with information across nine content areas that represent the core body of knowledge needed by patients with diabetes :
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- US NATIONAL STANDARDS
- ASSESSING LEARNER READINESS
- Barriers to readiness
- Social support
- Cultural competence
- PROVIDING DSME
- Teaching strategies
- - Individualized curriculum
- - Teachable moments
- - Scare tactics
- Time and expertise
- Behavior change
- Health outcomes
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS