Diabetes Self-Management Education to Improve Glycemic Control in a Community Clinic
AuthorHowell, Chelsea C.
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AbstractProblem: Diabetes Mellitus (DM) is a complex, chronic condition that if poorly controlled can result in substantial damage to the cardiovascular, visual, renal, and nervous systems. A community clinic in the Western United States saw a rise in uncontrolled DM patients, hemoglobin A1c greater than 9, from 37.0% to 46.1% from January 2020 to March 2021. Knowledge as well as application of daily self-care activities are essential to optimal glycemic control and overall health outcomes. Purpose: The purpose of this quality improvement (QI) initiative was to implement a structured diabetes self-management education (DSME) program including a combination of diabetes group classes, in addition to individualized provider visits to improve glycemic control, disease knowledge, and self-care activities in adults with uncontrolled Type 2 DM (T2DM). Methods: Candidates for the DSME program were identified through direct referrals and chart review for evidence of uncontrolled DM. Those who qualified and agreed to participate in the initiative provided verbal informed consent. Clinic staff were trained on the referral process and education materials were developed from the Association of Diabetes Care and Education Specialists (ADCES) 7 Self-Care Behaviors Framework. The number of new referrals was monitored weekly through chart review. Pre and post implementation chart review was instituted to detect changes in glycemic control, diabetes knowledge, self-care activities, blood pressure, cholesterol, and body mass index (BMI). Results: Results revealed a steady increase in the number of referrals for patients with uncontrolled DM to receive DSME from 0% to 70% respectively with an average of 15.78% of weekly DM referrals over time. Pre-mean A1c was 9.18% and post-mean A1c was 9.05%, for a decrease of 0.13%. There were minimal changes noted to the other clinical measures. Conclusions: A structured DSME program and referral process can be beneficial for glycemic control and DM management.
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Identifier to cite or link to this itemhttp://hdl.handle.net/10713/20833
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Except where otherwise noted, this item's license is described as Attribution-NonCommercial-NoDerivatives 4.0 International