Diabetes Self-Management Education and Support

Diabetes self-management education and support (DSMES) services are scientifically proven to improve management practices among people with diabetes, lowering the risk of complications and improving health outcomes.²¹

CDC supports states in their efforts to prevent serious and costly complications from diabetes. This support includes cooperative agreements, partnerships, surveillance, and research activities to improve access to, coverage for, and participation in DSMES. For example, state health departments funded by CDC are working with health care systems and other partners to establish or expand the use of telehealth to increase access to DSMES. Although DSMES are offered in 56% of counties across the United States, 62% of rural counties have limited access to these services.²¹ State health departments are also working to encourage more pharmacists to deliver DSMES services and help patients manage their medications.

In 2018, CDC released the DSMES Toolkit, a comprehensive set of resources and tools for state health departments and their partners, including organizations that deliver DSMES services. This toolkit supports the development, promotion, implementation, and sustainability of DSMES services.

Research shows that DSMES can also help lower health care costs by reducing hospitalizations, hospital readmissions, and emergency room visits for people with diabetes.²¹ Every year, nearly 1 million people with diabetes receive DSMES services recognized by the American Diabetes Association or accredited by the Association of Diabetes Care & Education Specialists.

In 2020, a total of 2,158 sites were delivering DSMES services across the United States. Recipients of CDC-funded cooperative agreements helped partners establish 140 new delivery sites. CDC promotes private and public insurance coverage for recognized or accredited delivery sites as a way to further expand access to DSMES services. Forty-three states require that most or all private health insurers cover DSMES services. Fifteen states require coverage for all or most Medicaid beneficiaries, and 18 additional states address Medicaid coverage through other Medicaid policies.²²