Diabetes Self-Management Education Service at a Rural Minnesota Health Clinic

In 2015, there were an estimated 30.3 million Americans living with diabetes, and 95% of them were diagnosed with type 2 diabetes (T2D) (Centers for Disease Control and Prevention, 2017b). Patients living in rural America have an increased prevalence of diabetes, and their participation rates in preventative care practice are lower (Rutledge, Masalovich, Blacher, & Saunders, 2017). The increased prevalence of the T2D in rural communities does not positively correlate with the number of diabetes self-management education (DSME) services in these areas, which poses a gap in healthcare services (Rutledge et al., 2017). Diabetes self-management education can be defined as ?the process of facilitating the knowledge, skill, and ability necessary for diabetes care? (Powers et al., 2015, p. 71). Diabetes self-management education has shown to decrease participant?s A1c by as much as 0.9%, which has been associated with a 25% reduction in microvascular complications, a 10% decline in diabetes-related mortality, and a reduction in all-cause mortality by 6% (Chrvala, Sherr, & Lipman, 2016). The utilization of DSME services in rural health clinics has the potential to improve health outcomes by decreasing complications directly related to diabetes in those patients participating in the service. The practice improvement project established a pilot DSME group service, which was consistent with the Standards of Medical Care in Diabetes - 2019 (ADA, 2018d). The practice improvement project was structured using the Chronic Care Model and Model for Improvement to help provide a functional and sustainable DSME service. The overall goal of the practice improvement project is to have the organization continue the service after the conclusion of the practice improvement project. The practice improvement project yielded positive results. The organization?s surveys indicated strong support for the service and the ability of the DSME service to fill a gap in their current diabetic education. The DSME participant?s skills and confidence increased through completing the curriculum, positively correlated to improved glycemic control. The organization?s stakeholders also felt that the service would be marketable to the organization?s patient population and profitable by increasing quality numbers and providing the opportunity for reimbursement