Chronic diseases—such as heart disease, cancer, diabetes, and arthritis—are the leading causes of death and disability in the United States. Heart disease accounted for 27% of deaths in California in 2005, while stroke caused 7% of deaths.  23% of all deaths in California in 2005 were due to cancer and 7,697 of adults in California died from diabetes mellitus.  In 2009, 20% of adults in California reported being diagnosed with arthritis, the most common cause of disability in the US.  Although chronic diseases are among the most common and costly health problems, they are also among the most preventable. Adopting healthy behaviors such as eating nutritious foods, being physically active, and avoiding tobacco use can prevent or control the devastating effects of these diseases.

The Chronic Disease Control Branch mission is to prevent and control chronic diseases. The branch supports evidence-based programs to promote healthy behaviors, conduct research, and improve prevention, diagnosis, and treatment of chronic disease. Critical to the success of these efforts are partnerships with local public health and education agencies, voluntary associations, private organizations, and federal agencies.  

Diabetes Care and Education – ADA Practice Group

The Diabetes Care and Education Dietetic Practice Group is a professional group that promotes quality diabetes care and education. DCE is comprised of dietetic professionals and other members of the American Dietetic Association (ADA). As leaders in the healthcare community, DCE members make positive contributions for people with diabetes and their families, the DCE membership, healthcare providers, other professional organizations and industry partners.

Accreditation is required for Medicare reimbursement of the G codes for DSMT. Accreditation does not, however, guarantee reimbursement. Although most payers require that a DSME/T program has accreditation, reimbursement criteria vary. For example, Medicare provides reimbursement for accredited DSMT programs that are considered “Certified Providers.” Many private payers require that provider agreements be in place prior to providing reimbursement.

At least one of the instructors must be a registered nurse, dietitian, or pharmacist. The instructors must have recent educational and experiential preparation in diabetes education and/or are a CDE. All instructors (including a CDE) will have documentation of at least 15 continuing education hours yearly specified as being diabetes-specific, diabetes-related, and behavior change self-management education strategies (e.g., AADE7 Self-Care Behaviors).

Diabetes education, also known as diabetes self-management training (DSMT) or diabetes self-management education (DSME), is defined as a collaborative process through which people with or at risk for diabetes gain the knowledge and skills needed to modify behavior and successfully self-manage the disease and its related conditions.

DSMT/DSME is an interactive, ongoing process involving the person with diabetes (or the caregiver or family) and a diabetes educator(s). The intervention aims to achieve optimal health status, better quality of life and reduce the need for costly health care.

Diabetes education focuses on seven self-care behaviors that are essential for improved health status and greater quality of life. The AADE7™ Self-Care Behaviors are:

• Healthy eating
• Being active
• Monitoring
• Taking medication
• Problem solving
• Healthy coping
• Reducing risks

Diabetes education is most often provided by diabetes educators. Diabetes educators give people with diabetes the knowledge, skills and tools they need to successfully manage their diabetes and avoid many of the complications associated with the disease.

Services of registered dietitians or nutritional professionals for diabetes training services and medical nutrition therapy (the costs of such services are covered but not as a billable RHC visit).

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