Structured diabetes self-management education and the NDSS Carolyn Hines Diabetes Education Manager Diabetes Victoria

Presentation outline NDSS registration The NDSS suite of structured diabetes self-management education programs for people with type 1 and type 2 diabetes Referral and contact details

The NDSS The NDSS is an initiative of the Australian Government administered with the assistance of Diabetes Australia State and Territory diabetes organisations are NDSS Agents delivering support, services and programs within their jurisdiction. Diabetes Victoria is the NDSS Agent in Victoria We encourage all people with diabetes to register with the NDSS for access to: Subsidised products through pharmacies Programs, events, services and structured diabetes self-management education programs

OzDAFNE (Dose Adjustment For Normal Eating) 5 day group education program for adults with type 1 diabetes using MDI (pump program coming) Skills-based structured diabetes self-management education matching insulin dose with carbohydrate intake Published in Diabetes Research and Clinical Practice; Feb 2016 Reduced by half episodes of severe hypoglycaemia and of DKA requiring hospital admission Significant reduction in diabetes-related distress 5 day group education program for adults with type 1 diabetes using MDI (pump program coming) Skills-based structured education matching insulin dose with carbohydrate intake: Nutrition: Carbohydrate calculation; Insulin dose adjustment: Match quick-acting insulin to carbohydrate using ratios; Comprehensive type 1 education: Hypos; sick days; physical activity; complications; Evidence Published in Diabetes Research and Clinical Practice; Feb 2016 12 month follow up data for 506 participants HbA1c reduced by 0.7 % in those with the highest baseline levels Reduced severe hypoglycaemia by half Reduced episodes of DKA requiring hospital admission by half Significant reduction in diabetes-related distress

DESMOND (Diabetes Education and Self Management for Ongoing and Newly Diagnosed) 1 day (6 hour) diabetes self-management education program for adults with type 2 diabetes Content includes: What is diabetes; Monitoring; Food choices; Physical activity; Strong focus on self-management planning, goal setting and personal reflection; Published in BMJ 2008 Compared with control group (individual diabetes education of equivalent time), results include: reduction in smoking, BP, weight and depression scores; increase in physical activity The program covers the key educational content around the self management of type 2 diabetes what is occurring in the body when living with type 2 diabetes, the impact of food and physical activity, potential long-term complications that can occur with poorly managed type 2 diabetes. pathology results mean, such as HbA1c, LDL, HDL and total cholesterol. BP, waist circumference and the target ranges for these results goal setting. There are quite a number of other important elements to this type of group education program. the participants story, to find out participants beliefs around type 2 diabetes and their own experiences living with diabetes there is also meeting other people with type 2 diabetes

Topic-specific suite Living with Insulin CarbSmart A range of short, 2-3 hours, topic-specific, group education sessions Based on DESMOND principles Provide an opportunity for people to learn more about specific topics of interest in a practical way Foot Smart Monitor Smart Med Smart Shop Smart Ready Set Go Let’s Move Living with Insulin – practical information about using insulin (T1 and T2) Ready Set Go Let’s Move - the first steps to making physical activity a part of a healthy lifestyle (T2) CarbSmart – the myths and facts of carbohydrates (T2 and GDM) FootSmart - practical information about checking and caring for feet (T1 and T2) MeterSmart – how to use a blood glucose meter to manage diabetes (T2) MedSmart – understand what medications are and how they work (T2) ShopSmart – a practical approach to healthy shopping (T1 and T2)

Referral details No referral required for all programs OzDAFNE requires letter from GP / Endocrinologist prior to program commencement Contact: Your state and territory diabetes organisation for booking details In Victoria, visit diabetesvic.org.au/events for online bookings Visit ndss.com.au for further information

The NDSS national standards In 2017, the NDSS National Evaluation Team developed eight quality standards for structured diabetes education based on international standards including NICE, ADA/AADE, IDF The NDSS suite of structured diabetes self-management education programs for people with type 1 and type 2 diabetes all meet the national standards Programs include: OzDAFNE DESMOND A range of topic specific programs