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MEDICAL CARE

Diabetes Self-Management

Education:

A Healthy Prescribing Habit to Treat Diabetes

By Kathy Ann LaCivita, MD, FACE, FACP

Statistics chronicling the growth and seriousness of diabetes in Every person with diabetes needs individualized education and
the San Antonio area are shocking. We now see patients as young support to carry out daily diabetes self-management and care to im-
as five years old with Type 2 diabetes, which is linked to diet and prove quality of life. Yet, less than 60 percent of people with dia-
obesity. These young patients are dependent on their parents to help betes receive formal diabetes education. Furthermore, there is an
them avoid the health complications diabetes causes over time, but average of nine years between the time a person is diagnosed with
typically, the parents are already at risk for Type 2 diabetes or have diabetes and enrollment in a DSME program – time during which
been diagnosed themselves. Diabetes can have an emotional and the body’s insulin resistance affects extremities and vital organs.
physiological impact on the entire family. As an endocrinologist at the Texas Diabetes Institute, I see many
Prescribing medication is an effective first-line treatment to con- patients with complications that could have been delayed or pre-
trol blood sugar, but it’s not sufficient on its own, as demonstrated vented through DSME. As chair of the Texas Diabetes Council, I
by the growing number of families with intergenerational cases of often talk with physicians who are not aware of how to take advan-
diabetes. As physicians, we can and should do more to help patients tage of DSME to help their patients. Here are some facts about
manage their diabetes and prevent new cases from occurring. Un- DSME that can help you empower patients to help themselves.
fortunately, it can be challenging for physicians to change familiar
practices, just as it can be difficult for patients to adopt healthy DSME is supported by major health organizations.
habits to improve their health. The American Diabetes Association (ADA) collaborated with the
“If diabetes education were a pill, would you prescribe it?” That American Association of Diabetes Educators, Academy of Nutri-
was the question posed at last year’s American Diabetes Association tion and Dietetics, and National Diabetes Education Program to
(ADA) Scientific Sessions by Margaret A. Powers, Ph.D., RD, CDE, develop a national joint position statement that supports DSME.
President, Health Care and Education, ADA. The American Medical Association and U.S. Centers for Disease
In her address, Dr. Powers cited studies comparing diabetes ed- Control and Prevention also support education to prevent diabetes
ucation and the diabetes pill metformin. She noted that diabetes ed- in people at risk for the disease.
ucation is as effective as metformin and has fewer side effects and The Texas Diabetes Council, in conjunction with the Texas De-
greater psychosocial benefits. To read the article, visit http://care.di- partment of State Health Services Diabetes Prevention and Control
abetesjournals.org/content/39/12/2101. Program developed a helpful toolkit based on the national stan-
dards. The toolkit is available online at tdctoolkit.org and offers free
Additional research shows that people who receive provider and patient education materials. There is also a new Dia-
DSME are more likely to: betes resource guide that was developed by a San Antonio collabo-
• Use primary care and preventive services. rative to link services available in town and give information to
• Take medications as prescribed. people with diabetes and the providers who care for them, available
• Control their blood glucose, blood pressure, and at diabetesresourcesguide.com.
cholesterol levels. Both of these resources offer referral forms and links to licensed
• Have lower health costs over time. diabetes educators or education programs in the area. Getting to
• Experience reduced stress related to diabetes. know licensed diabetes educators is an important first step in mak-

24 San Antonio Medicine • February 2018