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Spring/Summer 2014 Return to Outlook Main page »

Diabetes SIG Update

Caroline R. Richardson, MD, Diabetes SIG Chair

The Society of Behavioral Medicine integrates research, patient care and policy efforts to improve health through behavioral science. As part of its mission, SBM periodically releases position and policy statements. These policy statements can be cited in grants and presentations and provide concrete targets for guidelines and insurance plans. The Diabetes SIG would like to take this opportunity to update the general membership regarding recent position and policy statements specific to diabetes.   

Diabetes Self-Management Education and Support

Diabetes self-management education improves disease severity, reduces complications, and lowers costs. However, only 30 to 40% of individuals diagnosed with diabetes receive self-management education. Surveying of health insurance plans indicates that approximately half cover diabetes self-management education.  The most recent SBM position statement on diabetes “encourages legislation and other policies that require Medicare, Medicaid and Private Insurers to reimburse for DSM Education and Support 12 hours each year for everyone with diabetes”.  Specifically SBM endorses these policy recommendations:

  1. Support policies and legislation which a) require Medicare, Medicaid, and private insurers to cover 12 hours of diabetes self-management education per year and b) eliminate burdensome requirements of physicians and providers in order to supply diabetes self-management education.
  2. Require health organizations to diversify diabetes self-management education delivery and approach and expand reimbursement options.

See the position statement on diabetes self-management for more details: https://www.sbm.org/UserFiles/file/diabetes-brief_statement_short.pdf

Quality Care in Diabetes

Current assessments of diabetes care quality focus on provider values and priorities such as testing glycosylated hemoglobin and foot exams. These aspects are crucial, yet insufficient, for disease control and quality care assurance. However, according to the SBM position statement, “…quality diabetes care must also recognize and reflect a patient centered approach, defined by the Institute of Medicine as "respectful of and responsive to individual patient preferences, needs, and values, and ensure that patient values guide all clinical decisions" (Heisler et al., 2002; Institute of Medicine et al., 2001)”.

Measures of patient behaviors and patient-reported outcomes need to be integrated into standard care. SBM recommends that standard care include measures of:

  1. Health behaviors including physical activity, dietary intake, medication taking, and smoking status
  2. Diabetes-specific and generic quality of life
  3. Patient self-management goals
  4. Patient-centered diabetes care

The SBM Diabetes Quality Care Statement is located here: https://www.sbm.org/about/public-policy/statements/diabetes-measures-of-quality-of-care

Diabetes Education Materials

If you are looking for high quality diabetes related materials for patient education and counseling with a particular emphasis on self-management check out the National Diabetes Education Program web site: http://ndep.nih.gov/.  This web site includes a searchable database of print materials, videos, interactive web sites, and apps that relate to diabetes self-management.  All of the materials have been screened by experts for quality and classified into a variety of categories for easy searching.  Materials in a variety of languages are included in the database.

The Diabetes SIG would like to acknowledge and thank SBM members who contributed to the development and publication of these position statements including: Ben Gerber, Lisa Sharp, Edwin Fisher, the SBM Health Policy Committee and SBM Leadership.