Healthy Living with Diabetes (DSMP)
The Diabetes Self-Management workshop is given 2½ hours once a week for six weeks, in community settings such as churches, community centers, libraries and hospitals. People with type 2 diabetes attend the workshop in groups of 12-16. Workshops are facilitated from a highly detailed manual by two trained Leaders, one or both of whom are peer leaders with diabetes themselves.
Subjects covered include: 1) techniques to deal with the symptoms of diabetes, fatigue, pain, hyper/hypoglycemia, stress, and emotional problems such as depression, anger, fear and frustration; 2) appropriate exercise for maintaining and improving strength and endurance; 3) healthy eating 4) appropriate use of medication; and 5) working more effectively with health care providers. Participants will make weekly action plans, share experiences, and help each other solve problems they encounter in creating and carrying out their self-management program. Physicians, diabetes educators, dietitians, and other health professionals both at Stanford and in the community have reviewed all materials in the workshop.
Each participant in the workshop receives a copy of the companion book, Living a Healthy Life with Chronic Conditions, 4th Edition, and an audio relaxation tape.*
It is the process in which the program is taught that makes it effective. Classes are highly participative, where mutual support and success build the participants’ confidence in their ability to manage their health and maintain active and fulfilling lives.
Great video for Providers interested in offering the program for their patients:
Great video for individuals diagnosed with Diabetes who are interested in the workshops:
The program does not conflict with existing programs or treatment. Treatment is not altered. For medical questions, participants are referred to their physicians or diabetes educators. If the content of the workshop conflicts with instructions they receive elsewhere, they are advised to follow their physicians’ orders and discuss discrepancies with the physician.
The original Diabetes Self-Management Program was developed in Spanish. After successful outcomes were found with that program, the received a grant from the for the randomized, controlled study to test the workshop’s effectiveness for English-speakers. The study was completed in 2008.
Six months after the workshop, participants had significant improvements in depression, symptoms of hypoglycemia, communication with physicians, healthy eating, and reading food labels. They also had significant improvements in patient activation and self-efficacy. At 12 months, DSMP participants continued to demonstrate improvements in depression, communication with physicians, healthy eating, patient activation, and self-efficacy. There were no significant changes in utilization or A1C (A1C values were already in the desirable range at the beginning of the study for most particpants).**
Community-based organizations can play an integral role in expanding the use of Medicare’s Diabetes Self-Management Training (DSMT) benefit among under-served older adults with a diagnosis of diabetes by using Stanford’s Diabetes Self-Management Program as the core curriculum of an expanded program that meets the ten National Standards. According to the Centers for Medicare & Medicaid Services (CMS) data for 2011, 28% of Medicare beneficiaries have a diagnosis of diabetes, yet the American Association of Diabetes Educators (AADE) estimates that only 1.5% of eligible Medicare beneficiaries have used their DSMT benefit. Trainings are available here in Arizona as full 4 day Leader training or 2 day cross-training for those who are already trained in Healthy Living (CDSMP). See our for more information.
*Living a Healthy Life with Chronic Conditions by Lorig, Sobel, Laurent, González and Minor (2006), as well as the audio CD can be ordered from . **Results reported in: Lorig K, Ritter PL, Villa FJ, Armas J, Community-based peer-led diabetes self-management: a randomized trial. Diabetes Educator, 35(4):641-651, 2009. General information provided from Stanford Patient Education Research Center’s website: