Diabetes Self-Management Education (DSME) a Patient-Centered Approach

Patient-centered care is defined as an approach to “providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions”.  At SMART Nutrition, we see diabetes self-management education as a critical component of care for people with diabetes.  It isn't a singular event but rather an ongoing process of facilitating knowledge, skill, and ability necessary for self-care leading to improved health outcomes and quality of life.  Our Patient-centered principle defines our approach for working with individuals with any chronic disease such as those patients diagnosed with any form of Diabetes.  The overall objectives of DSME are to support informed decision-making, self-care behaviors, problem-solving and active collaboration with the health care team and to improve clinical outcomes, health status, and quality of life.  SMART Nutrition strives to accomplish these objectives via a collaborative approach.  We work with patients who ultimately make the final decisions regarding their lifestyle choices and, to some degree, the pharmaceutical interventions they use.

Healthcare professionals agree that diet, exercise, and education remain the “foundation” of any diabetes treatment program.

Our goals of Medical Nutrition Therapy (MNT) is tailored to patients from a Primary (prevent disease), Secondary (prevent complications), and Tertiary (prevent morbidity and mortality) approach.  Expected MNT outcomes are to 1) achieve and maintain better control of blood glucose, blood lipid, and blood pressure in the respective normal range or as close to normal as is safely possible. 2) Prevent or slow the chronic complications rate often associated with diabetes via modification of nutrition intake and lifestyle choices. 3) Address individual nutrition needs while taking into account personal and cultural preferences and willingness to change eating behaviors. And 4) maintain the pleasure of eating by only limiting food choices when indicated by scientific evidence.

SMART Nutrition offers all patients at risk for diabetes or those patients diagnosed with any form of diabetes a tailored and collaborative approach to better manage their altered metabolic condition using most current American Diabetes Association, Academy of Nutrition and Dietetics, and American Association of Clinical Endocrinologists evidence based practices.  Our goal is to provide patients with the tools, skills, and resources they will need and are able to use to help them achieve better blood glucose control while working with your primary healthcare provider and/or endocrinologist.

After an Assessment, we develop a patient specific education/counseling plan that covers the following DSME topics:

  • An overview of the disease process
  • Prevention, detection, and treatment of disease acute and chronic complications
  • Medication Management Review
  • Nutrition Impact on Blood Glucose control
  • Using Diabetes Self-Management “best-practice”, evidence-based support tools and resources to improve blood glucose control
  • Applyng an appropriate Meal Plan template based on energy need, lifestyle, and of course goal(s) or desired outcomes
  • Using Nutrition-related tools and/or resources (e.g. Carb-Counting, Exchanges books, Food labels, recipes,etc)
  • Review of blood glucose and ketones monitoring skills and ideal goals according to ADA and AACE recommendations
  • Review of physical activity relationship to improved Blood Glucose, Blood Pressure, Blood Lipids, and Body Weight
  • Psychosocial adjustments
  • Problem-solving
  • Impact of Stress on Blood Glucose control
  • Sickness and Diabetes Control Concerns
  • Travel and Diabetes Control Concerns
  • Dietary and Lifestyle Strategies to Control Blood Pressure
  • Dietary and Lifestyle Strategies to Control Blood Lipid Levels