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MEDICAL CARE

ing DSME part of your practice. It’s also important to note that
DSME is covered by Medicare and most health plans when pro-
vided by a diabetes educator in an accredited/recognized program.

Physician attitudes are key to making DSME a success.
Patients tend to mirror their physician’s attitudes about therapies.
If a physician does not endorse DSME, patients may not take it se-
riously and therefore, may not succeed in developing self-manage-
ment skills. Patients are more likely to be successful if the physician
endorses DSME as an effective diabetes treatment and expresses
confidence in the patient’s ability to self-manage.
Physician support is especially important for patients who may
not feel they have the time or money for DSME. One of the most
important messages physicians can share is that DSME can help
improve health and quality of life for the entire family.
Physicians who have not had experience with DSME – or whose
patients have not benefited in the past – are encouraged to review
these resources and learn more about the process and local diabetes
education programs.

Referral for DSME should be considered at specific
times.
The joint position statement identifies four times when referral
for DSME should be considered:
• At diagnosis.
• At an annual assessment of education, nutrition, and emotional
needs.
• When complicating factors influence self-management. Compli-
cations may include changes in health conditions, physical limi-
tations, emotional factors, or living situation.
• When transitions in care occur. Transitions may include changes
in the living situation, medical care team, insurance coverage, or
age-related changes.
type 2 diabetes within five years without weight loss and exercise.
As an endocrinologist, I often see patients who are well on their By the time diabetes is diagnosed, damage to the pancreas cells has
way to developing complications or are already dealing with serious already occurred. The earlier self-management begins, the greater
complications from diabetes. Many of these complications could the opportunity to prevent complications from occurring.
be delayed or prevented if patients practice effective self-manage-
ment techniques that are taught by diabetes educators. Kathy Ann LaCivita, MD, is a Board-certified endocrinol-
I encourage primary care providers to refer patients for DSME, ogist and Medical Director who specializes in the treatment of
as recommended by the joint position statement. Patients with pre- diabetes at the University Health System’s Texas Diabetes In-
diabetes can also benefit from education to help them prevent dia- stitute, one of the nation’s largest and most comprehensive di-
betes from developing. One out of eight Bexar county adults has abetes centers. The DSME toolkit and other free resources are
prediabetes. Thirty percent of people with prediabetes will develop available through the Texas Diabetes Council at tdctoolkit.org.

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