DM Full Guideline (2010) - VA/DoD Clinical Practice Guidelines Home

Version 4.0
MODULE M: SELF-MANAGEMENT& EDUCATION
ANNOTATIONS
VA/DoD Clinical Practice Guideline
for the Management of Diabetes Mellitus
A. Is This a Patient With Newly Diagnosed Diabetes Mellitus?
Module M applies to patients who have been diagnosed with diabetes mellitus (DM) and require diabetes selfmanagement
education (DSME) as well as knowledge and skills to facilitate implementation of their treatment plan.
B. Provide Information and Education on Basic Concepts and Core Competencies, Document Findings
OBJECTIVE
Ensure that patients with diabetes understand the core competencies (survival skills) and other basic information so
that they may safely self-manage their diabetes.
RECOMMENDATIONS
1. Ensure that patients newly diagnosed with DM are provided with core competency education.
The core competencies include:
• Acute complications (hyperglycemia and hypoglycemia)
• Medication education
• Self-monitoring of blood glucose and how to use the results
• Basic diet principles
• Sick day management
• When to seek further assistance
(See Appendix M-1: Core Competencies [Survival Skills] for Patients with Diabetes).
DISCUSSION
Core competency education addresses basic principles of diabetes management. Individuals receiving insulin, and
other high-risk populations may benefit from a comprehensive DSME program.
Patient education materials identified in the following appendices as well as other patient education materials can be
made available to the patient in the office setting to assist the healthcare team in addressing additional concepts and
information not included in the core competencies:
C. Refer for Comprehensive Diabetes Self-Management and Diet Education
OBJECTIVE
Provide or refer for comprehensive Diabetes Self-Management Education (DSME) and Medical Nutrition Therapy
(MNT) education.
BACKGROUND
Diabetes self-management is considered necessary by most healthcare organizations to assist persons with diabetes
(a) in their day-to-day self-management demands and (b) with making informed self-care choices. This includes
providing behavioral strategies that establish and maintain a healthy lifestyle. Since the diabetes clinical state
fluctuates within individuals over their life span, education programs need to be comprehensive enough to provide
clinical knowledge and skills to facilitate implementation of the changing treatment plans.
RECOMMENDATIONS
1. Patients newly diagnosed with diabetes should receive comprehensive DSME and education for MNT.
2. DSME, including MNT education, should be an interactive, collaborative, ongoing process involving
patients with diabetes and educators and include the following four-step process:
o
o
o
Assessment of the patient’s educational needs
Identification of the patient’s specific self-management goals
Education and behavioral interventions aimed at meeting the patient’s goals
Module M: Self-management Page 108