Ruppert and colleagues examined patients' diabetes risk factors, comorbid conditions, and patient participation in primary care practitioner (PCP) referrals to a rural diabetes self-management education (DSME) program. A total of 295 patients in a rural community were identified by their PCP as having type 2 diabetes (T2D). Using patient information that was collected and entered into a diabetes data management system, patients' risk factors, comorbid conditions, and patient participation in and PCP referral patterns to a DSME program were examined. Of the 295 patients with T2D, 162 (65%) reported that they had never received any DSME services. Despite educator efforts to improve patient participation and PCP awareness of local DSME services, 123 (76%) of the 162 patients never received a subsequent referral for DSME. Those patients who did receive a referral had a higher number of risk factors and comorbid conditions than those who did not receive a referral. Eighty-three percent of the patients who received a PCP referral attended the DSME program.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that the findings reaffirm concerns that DSME patient participation and PCP referral practices are poor. Advocacy efforts should force policies and procedures that will make DSME a mandatory service and universally accessible.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE CONSUMER: The investigators conclusions are warranted: every patient with diabetes should receive self-management training. This is particularly the case as there are likely more proven and available self-management programs for diabetes than for any other chronic condition.

K Ruppert et al. Examining Patient Risk Factors, Comorbid Conditions, Participation, and Physician Referrals to a Rural Diabetes Self-management Education Program. Diabetes Education, May 17, 2010.