Table 2

Key definitions

Diabetes self-management education and support (DSMES)
 • DSMES (40): The ongoing process of facilitating the knowledge, skills, and ability necessary for diabetes self-management as well as activities that assist a person in implementing and sustaining the behaviors needed to manage his or her condition on an ongoing basis, beyond or outside of formal self-management training. This process incorporates the needs, goals, and life experiences of the person with diabetes.
 • Support (40): Helps implement informed decision making, self-management behaviors, problem solving, and active collaboration with the health care team to improve clinical outcomes, health status, and quality of life.
 Note: Diabetes services and specialized providers and educators often provide both education and support. Yet on-going support from the primary health care team, family and friends, specialized home services, and the community are necessary to maximize implementation of needed self-management.
 Note: CMS uses the term “training” (DSMT) instead of “education” (DSMES) when defining the reimbursable Medicare benefit. Education is used in the National Standards for Diabetes Self-Management Education and Support and more commonly used in practice. In the context of this article, the terms have the same meaning.
Person-centered care (96)
 • Providing care and education that is respectful of and responsive to an individual person’s preferences, needs, and values and ensuring that those values guide all clinical decisions.
Diabetes-related distress (23,26,97)
 • Diabetes-related distress is defined as the emotional burden of diabetes, the constant demands from diabetes self-management (taking and adjusting medications, monitoring blood glucose, meal planning, and physical activity) and the possibility of developing complications, and the lack of support and access to care.
 • The emotional burden of diabetes has the greatest impact on diabetes distress and outcomes.
Diabetes care and education specialist (DCES) (98)
 • A trusted expert of the integrated care team who provides collaborative, comprehensive, and person-centered care and education to persons with diabetes and related cardiometabolic conditions.
 Note: In 2019 a new title to identify health professionals who specialize in diabetes care and education was created by the Association of Diabetes Care & Education Specialists. Clinical staff who qualify for this title may or may not be a CDCES or BC-ADM, yet all who hold the CDCES and BC-ADM certifications are diabetes care and education specialists.
Certified Diabetes Care and Education Specialist (CDCES) (99)
 • A health care professional who has completed a minimum number of hours in clinical diabetes practice, passed the Certification Examination for Diabetes Care and Education (administered by the Certification Board for Diabetes Care and Education [CBDCE]), and has responsibilities that include the direct provision of diabetes education.
 Note: The Certified Diabetes Educator (CDE) certification title is now CDCES.
Board Certified-Advanced Diabetes Management (BC-ADM) (100)
 • A health care professional who has completed a minimum number of hours in advanced diabetes management, holds a graduate degree, passed the BC-ADM certification exam (administered by the Association of Diabetes Care & Education Specialists), and has responsibilities of an increased complexity of decision making related to diabetes management and education.
Social determinants of health (11,83)
 • The conditions in which people live, work, learn, play, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies, and political systems.