New guidelines include most substantial changes since standards first introduced, including easier documentation of services and clarity around reporting outcomes
New updates to the National Standards for Diabetes Self-Management Education and Support (National Standards) call for addressing health equity by improving access to diabetes self-management education and support (DSMES) services, a renewed focus on increasing and maintaining person-centered care and reducing administrative burden.
Issued by the Association of Diabetes Care & Education Specialists (ADCES) and the American Diabetes Association® (ADA), the 2022 update – including some of the biggest changes since the National Standards were first introduced in 1984 – will be published in the February issues of The Science of Diabetes Self-Management and Care and Diabetes Care.
“The newly revised National Standards include revisions to help reduce administrative burden for the diabetes care and education specialist while allowing for more time and focus on providing person-centered education and care to the person with diabetes,” said Leslie Kolb, RN, BSN, MBA, ADCES chief science, practice and education officer. “These changes address the evolving current and future workforce and health care landscape.”
Diabetes is a complex disease that requires daily self-care to effectively manage glucose levels and help prevent potentially deadly and costly complications. DSMES provides people with diabetes and caregivers with the knowledge, skills, and abilities critical for effective diabetes self-management and helps people with diabetes implement and sustain behaviors needed to most effectively manage their condition throughout their lifetime.
DSMES services are guided by the National Standards, and the guidelines are updated and published every five years.
According to the Centers for Disease Control and Prevention’s most recent estimates, 34.2 million people – 10.5% of the US population – had diabetes (diagnosed or undiagnosed) in 2018. An estimated 84 million people are at increased risk for developing Type 2 diabetes.
“The National Standards for DSMES provide diabetes care and education specialists with structure to guide their services. Timely revision by our colleagues in diabetes care and education align the standards with current evidence-based practices and utilization trends,” says Dr. Laura Hieronymus, DNP, MSEd, RN, MLDE, BC-ADM, CDCES, FADCES, ADA Vice President, Health Care Programs. “These updates reflect research for diabetes education and support, behavioral health, clinic and health care environment, technical, and sustainability of business practice.”
The ADCES and ADA use the National Standards criteria in accrediting DSMES services. The Standards are required for Medicare-specific reimbursement and outline recommendations for process, structure and outcomes related to high-quality DSMES services.
The 2022 National Standards update provides recommendations and guidelines applicable to DSMES in small, solo practices, as well as those in large, multicenter facilities; care coordination programs; population health programs; and technology-enabled models of care.
Updates to the National Standards that aim to increase access and improve health equity by reducing barriers to this critical service include:
- Streamlining to reduce the number of standards from 10 to six
- Combining the quality coordinator and DSMES team under one standard to reflect the important role the entire care team provides. More clearly defined qualifications and requirements for DSMES team members is also included.
- More strongly emphasizing personalizing DSMES and ongoing patient support and follow-up.
- Reducing administrative burden by providing a clear documentation structure for DSMES services that can be implemented in any paper or electronic system as well as an emphasis on the importance of communication and collaboration across the care team.
- Emphasis on the importance of organizational support for DSMES services.
- Clarity around reporting metrics and outcomes for Continuous Quality Improvement.
The 2022 National Standards Revision Taskforce consisted of 22 diabetes care and education specialists who are experts from numerous health care professional disciplines — including physicians, nurses, pharmacists, registered dietitians, and persons with diabetes. The group based the National Standards on an extensive and comprehensive body of literature.
The complete Standards will be published online in Diabetes Care at http://care.diabetesjournals.org/lookup/doi/10.2337/dci17-0025 and in The Science of Diabetes Self-Management and Care at https://journals.sagepub.com/doi/full/10.1177/26350106211072203 on Thursday, Jan. 20, 2022.
 Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2020. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2020.