Purpose: The persistent requirement of self-management for diabetes impacts quality of life (QoL), yet the literature for impact of diabetes self-management education and support (DSMES) on QoL in youth has not been synthesized and reported. The purpose of this review was to systematically identify and describe the state of the science exploring the impact of DSMES on self-reported QoL in youth with type 1 diabetes (T1DM) or type 2 diabetes (T2DM). Methods: A modified Cochrane review was conducted. Retained studies were published in the English language between January 1, 2007, and March 31, 2020. Included studies specified that the intervention had diabetes education addressing at least 1 or more of The Association of Diabetes Care & Education Specialists’ ADCES7 Self-Care BehaviorsTM (ADCES7™) and used an established self-reported QoL measure. Retained studies were assessed for risk of bias. Results: Eleven studies reported in 12 articles were retained. The interventions were primarily delivered to youth with T1DM or T2DM and included caregivers/families in some studies. The ADCES7™ were addressed across the retained studies. Five of the 11 studies assessed QoL as the primary outcome and 6 studies as a secondary outcome. Conclusion: To enhance the QoL outcomes and to provide insight into how to positively impact self-perceptions of QoL, ongoing generic and diabetes-specific QoL assessments are warranted for youth with T1DM or T2DM. Further research is needed in structured DSMES programs to help reduce variability in research designs, methods, measures, and outcomes to generate evidence for best practices that can be translated and disseminated into real-world settings.
Diabetes educators can be challenged by therapeutic inertia, as has been documented with other health care providers. There are many contributing factors related to the educators themselves, their patients, and the health care system in which they operate. To address this potentially significant barrier to quality patient care, diabetes educators can adopt numerous strategies to maximize their impact and address the factors contributing to therapeutic inertia in their practices.
Type 1 diabetes (T1D) is a chronic disease that influences all health aspects. The self-determination theory (SDT) suggests that three psychological needs of competence, autonomy, and relatedness are necessary for motivation to engage in healthy behaviors. Through medical specialty camps, these needs can be met by educating campers on how to manage T1D and realize they are not alone. The volunteer-based, five-day, inaugural tween–teen camp for youth with T1D was held on the campus of a university. The entire camp experience was engineered around the three basic needs described by the SDT. These needs were promoted by physical and educational activities and meeting friends. The Basic Psychological Needs and Frustration Scale was administered as a pre-, post-, and follow-up test. Two of the four measures were significant, the autonomy pretest (M = 3.93; SD = 0.75) to posttest (M = 4.49; SD = 0.56), with t(25) = −6.258; p ≤ 0.001) and relatedness pretest (M = 4.31; SD = 0.79) to posttest (M = 4.53; SD = 0.49), with t(25) = −2.168; p = 0.040; however, mean scores declined at the 3-month follow-up. Campers’ blood glucose levels were collected through an online platform that allowed staff to monitor blood glucose levels, with the week’s average being 150 mg/dL, and almost 71% remaining in the TIR. The results can be helpful for practitioners who want to use the SDT to structure and examine the effectiveness of medical specialty camps for youth with T1D.