October 20, 2014
Is Internet DSME Beneficial?
People with type 2 diabetes can benefit from diabetes self-management education (DSME) and it does not need to be taught by certified diabetes educators. If done correctly and people with type 2 diabetes will learn, the internet can be a great place to learn and sharpen diabetes management skills.
Self-management of diabetes, includes medication, nutrition (food plan), and lifestyle strategies. This is essential for optimal glycemic control and minimizing complications of the diabetes. Education to teach and improve self-management skills is critical for success and, when delivered via the Internet, can lead to better glycemic control and enhanced diabetes knowledge compared to usual care.
“Katherine Pereira, DNP, Beth Phillips, MSN, Constance Johnson, PhD, and Allison Vorderstrasse DNSc, Duke University School of Nursing (Durham, NC), review various methods of delivering diabetes education via the Internet and compare their effectiveness in improving diabetes-related outcomes. In the article "Internet Delivered Diabetes Self-Management Education: A Review," the authors describe some of the benefits of this method of educating patients, including ease of access and the ability to self-pace through the materials.”
DSME delivered via the Internet is effective at improving measures of glycemic control and diabetes knowledge compared with usual care. In addition, results demonstrate that improved eating habits and increased attendance at clinic appointments occur after the online DSME. The researchers discovered that engagement and usage of Internet materials waned over time. Interventions that included an element of interaction with healthcare providers were seen as attractive to participants.
Internet-delivered diabetes education has the added benefit of easier access for many individuals, and patients can self-pace themselves through materials. More research on the cost-benefits of Internet diabetes education and best methods to maintain patient engagement are needed, along with more studies assessing the long-term impact of Internet-delivered DSME.
I commend the individuals involved for realizing that the Internet could help with diabetes self-management education. The increasing numbers of people with diabetes is resulting in limited availability and access to diabetes care services. This includes access to certified diabetes educators. It is estimated that there is about one certified diabetes educator per 1,400 patients with diabetes in the United States. Because of the many factors limiting access to diabetes education, innovative delivery methods for DSME will need to be developed. One potential avenue that has been studied over the last decade for addressing the reach and accessibility of DSME is the use of Internet-based interventions.
DSME as a vital component of the care of patients with diabetes and the ADA recommends that DSME be provided for every patient at the time of diagnosis of diabetes and as needed thereafter. Despite these recommendations and the proven effectiveness of DSME, many patients with diabetes never receive DSME or any form of diabetes education.
If the future plans of the American Association of Diabetes Educators come to fruition, then there may be some hope. With the Academy of Certified Diabetes Educators staying with the exclusive idea that they are the only ones capable of providing diabetes education, we cannot expect any help from them.
The full copy of the report is available to read here until November 6 and then it goes behind a pay wall.