Diabetes Self-Management Education Patterns in a US Population-Based Cohort of Youth With Type 1 Diabetes
Authors: Jaacks Lindsay M. , Bell Ronny A. , Dabelea Dana , D’Agostino Ralph B. , Dolan Lawrence M. , Imperatore Giuseppina , Klingensmith Georgeanna , Lawrence Jean M. , Saydah Sharon , Yi-Frazier Joyce , Mayer-Davis Elizabeth J. ,   for the SEARCH for Diabetes in Youth Study Group, Lawrence Jean M. , Reynolds Kristi , Hsu Jin-Wen , Black Mary Helen , Holmquist Kim , Takhar Harpreet S. , Kershnar Ann K. , Pettitt David J. , Dabelea Dana , Hamman Richard F. , Testaverde Lisa , Klingensmith Georgeanna J. , Rewers Marian J. , Maahs David , Wadwa Paul , Daniels Stephen , Nadeau Kristen , Bloch Clifford A. , Sorrelman Carmelita , Beartrack Alfreda , Rodriguez Beatriz L. , Fujimoto Wilfred , Curb J. David , Kennedy Fiona , Uramoto Greg , Waxman Sorrell , Chung Richard , Waitzfelder Beth , Hillier Teresa , Dolan Lawrence M. , Seid Michael , Urbina Elaine , Standiford Debra A. , Mayer-Davis Elizabeth J. , Thomas Joan , Merchant Anwar , Liese Angela D. , Moran Robert R. , Gaillard-McBride Gladys , Lawler Deborah , Jackson Malaka , Bowlby Deborah , Amrhein James , Clark Pam , Parker Mark , Pihoker Catherine , Afkarian Maryam , Badaru Angela , Gilliam Lisa , Hirsch Irl , Liu Lenna L. , Neff John , Yi-Frazier Joyce , Loots Beth , O’Connor Rebecca , Kearns Sue , Klingsheim Mary , Buscaino Emil , Cochrane Katherine , Martinez Onel , Semana Sharla , Greenbaum Carla , Imperatore Giuseppina , Williams Desmond E. , Kahn Henry S. , Moore Bernice , Edward Gregg W. , Saydah Sharon H. , Linder Barbara , Marcovina Santica M. , Gaur Vinod P. , Harting Jessica , Bell Ronny , D’Agostino Ralph , Beech Bettina , Case Douglas , Divers Jasmin , Morgan Timothy , Naughton Michelle , Henkin Leora , Moxley Susan , Hargis Gena , Kronner Donna , Goldstein Maureen T. , Anderson Andrea , Andrews Jeanette , Lauer Abigail , Talton Jennifer 
Published: November 2013

Purpose

The purpose of this study is to describe (1) the receipt of diabetes self-management education (DSME) in a large, diverse cohort of US youth with type 1 diabetes (T1DM), (2) the segregation of self-reported DSME variables into domains, and (3) the demographic and clinical characteristics of youth who receive DSME.

Methods

Data are from the US population-based cohort SEARCH for Diabetes in Youth. A cross-sectional analysis was employed using data from 1273 youth <20 years of age at the time of diagnosis of T1DM. Clusters of 19 self-reported DSME variables were derived using factor analysis, and their associations with demographic and clinical characteristics were evaluated using polytomous logistic regression.

Results

Nearly all participants reported receiving DSME content consistent with “survival skills” (eg, target blood glucose and what to do for low or high blood glucose), yet gaps in continuing education were identified (eg, fewer than half of the participants reported receiving specific medical nutrition therapy recommendations). Five DSME clusters were explored: receipt of specific MNT recommendations, receipt of diabetes information resources, receipt of clinic visit information, receipt of specific diabetes information, and met with educator or nutritionist. Factor scores were significantly associated with demographic and clinical characteristics, including race/ethnicity, socioeconomic status, and diabetes self-management practices.

Conclusions

Health care providers should work together to address reported gaps in DSME to improve patient care.