Do you have prediabetes or diabetes? If so, you are not alone. Nearly half of adults in Iowa have been diagnosed with diabetes or are at high risk of developing type 2 diabetes.
The good news is that there are ways to prevent or delay diabetes while also reducing the risk of other serious complications, like heart disease, stroke and kidney failure. Iowa HHS and community partners offer low-cost, effective programs to support diabetes prevention and management so Iowans can have a happier, healthier quality of life.
Prediabetes means your blood sugar levels are higher than normal but not high enough to be diagnosed with type 2 diabetes. This condition can persist for years without any noticeable symptoms while you are at risk of developing other serious health conditions like heart disease and stroke.
Do You Have Prediabetes? Take the Quiz.
Learn more about your risk for prediabetes. Take the 7-question Prediabetes Screening Test. Share your score with your doctor and ask about steps you can take to improve your health.
Are an African American, Hispanic or Latino American, American Indian or Alaskan Native person (some Pacific Islander people and Asian American people also have a higher risk).
Get more information about risk factors for prediabetes, its effects and what you can do to prevent type 2 diabetes. Download this fact sheet, which is also available in Spanish and:
If you want to make healthy changes to prevent type 2 diabetes, a lifestyle change program can offer support to build better habits that can last a lifetime.
Topics include eating healthy, adding physical activity to your routine, managing stress, staying motivated and solving problems that can get in the way of your goals with the support of:
Lessons, handouts and other resources to help you make healthy changes.
A specially trained lifestyle coach to provide education, motivation and engagement.
A support group of people with similar goals and challenges to share ideas, celebrate successes and work to overcome obstacles.
Talk with your healthcare provider and find more information below.
The National Diabetes Prevention Program (National DPP) is a partnership of public and private organizations working together to make it easier for people to participate in the evidence-based lifestyle change program. The Centers for Disease Control and Prevention (CDC) approves the PreventT2 curriculum and offers it to facilitators for free.
Referring at-risk patients to a CDC-recognized lifestyle change program reinforces the important advice you give during visits and can reduce their risk of type 2 diabetes by more than half. Below is information about the program, tools to help you talk with your patients, eligibility criteria and resources for easy referrals.
To receive CDC recognition, you must demonstrate your organization’s ability to meet CDC guidelines and effectively deliver a lifestyle change program. These standards for CDC recognition include:
The use of a CDC-approved curriculum. You can use the PreventT2 curriculum developed by the CDC, build your own or use that of another organization with permission and CDC approval.
The ability to begin offering the lifestyle program within six months of receiving approval from CDC.
The capacity and commitment to deliver the program over at least one year, including at least 16 sessions during the first six months and at least six sessions during the last six months.
The ability to submit participant progress data every six months, including weight and physical activity minutes collected at each session.
A trained lifestyle coach to lead the sessions and encourage participants to make lasting lifestyle changes.
A program coordinator to oversee the program’s daily operations, support the lifestyle coaches and ensure the program meets quality performance outcomes.
A data preparer to collect and submit data to the CDC.
Whether you are newly diagnosed with diabetes or have been living with it for years, diabetes self-management education and support (DSMES) can provide you with the knowledge, skills and confidence needed to handle daily care of your condition and improve your overall quality of life.
With personalized and group coaching options, you will work with your diabetes care team and an education specialist to create a plan to help you:
Improve your hemoglobin A1C, blood pressure and cholesterol.
Have fewer or less severe diabetes complications.
Save money on healthcare costs.
Reduce the need for emergency care.
Stay on track with your treatment plan and prescriptions.
Learn practical tips for eating healthy, being active and solving problems.
Handle the emotional side of diabetes.
Ask your doctor for a referral to a DSMES program to get help managing your diabetes.
DSMES for Healthcare Providers
While DSMES is highly effective in improving health and diabetes management skills, less than 7% of eligible patients participate within the first year of diagnosis, according to the CDC. Healthcare providers like you are the best way to increase access to these essential services.
Better health management can help people with diabetes and their healthcare teams prevent or delay complications and live longer healthier lives. Referring patients to DSMES services can also help you meet follow-up care guidelines.
The best times to refer patients are:
When they are diagnosed with diabetes.
During healthcare appointments.
When new health complications arise.
When other life changes could make diabetes management harder.
Use these tools to promote diabetes self-management programs in your community:
Get Help Taking Control of Your Diabetes, Iowa HHS
Setting up a new diabetes self-management education and support program in your community will improve access to vital services and help decrease the barriers for patients living with diabetes.
Accreditation and recognition processes help ensure quality education and make DSMES services eligible for reimbursement from Medicare, some state Medicaid agencies and many private health plans. Accrediting organizations for DSMES services recognized by the Centers for Medicare and Medicaid Services (CMS) are:
In Iowa, DSMES programs can become state-certified to receive Medicaid and other third-party reimbursement. The Iowa HHS certifies diabetes outpatient education programs that adhere to the quality standards outlined in 641 Iowa Administrative Code, Chapter 9.
Programs must submit an initial application with the required documentation to obtain state certification. Every four years, state-certified programs must demonstrate that they have maintained the necessary documentation and submit for recertification.
At least one of the team members responsible for facilitating DSMES services must be one of the following:
Registered nurse (RN)
Registered dietitian/nutritionist (RD/RDN)
Pharmacist with training and experience pertinent to DSMES (PharmD)
Healthcare professional holding certification as a Diabetes Care and Education Specialist (CDCES) or a Board Certification in Advanced Diabetes Management (BC-ADM)
Other healthcare teams may contribute to providing DSMES services with appropriate training in DSMES and supervision and support by at least one of the team members listed above.
Chronic Disease Self-Management (Better Choices, Better Health) Program
Diabetes can affect nearly every aspect of a person’s life and often accompanies other serious conditions. The chronic disease self-management program (CDSMP), known in Iowa as Better Choices, Better Health, supports adults living with various chronic conditions through an evidence-based approach.
Better Choices, Better Health focuses on:
Teaching disease management skills.
Building confidence.
Improving physical and psychological well-being.
Groups range in size from 8 to 16 participants and meet for two hours a week for six weeks. Activities include:
Interactive discussions, brainstorming, action-planning and feedback, behavior modeling, problem-solving techniques, and decision-making.
Symptom management activities include exercise, relaxation, communication, healthy eating, medication management, and managing fatigue.
Ask your doctor how to locate a Better Choices, Better Health program near you.
Chronic Disease Self-Management for Healthcare Providers
Studies show that people who participate in chronic disease self-management programs like Better Choices, Better Health significantly improve and maintain healthy behaviors, lowering their risks for further complications.
Use the resources below to educate staff about the benefits of self-management programs and encourage your patients to participate in these low-cost, evidence-based programs.
With oversight from the Self-Management Resource Center (SMRC), requirements for CDSMP workshops, including Better Choices, Better Health, are:
Each workshop is led by two trained peer leaders, one or both of whom are non-health professionals. At least one of the leaders should have a chronic condition themselves.
Leaders must have SMRC training and renew their licenses every three years.
Workshops must be held in a community space that is accessible under the Americans with Disabilities Act (ADA), with enough space for leaders and participants, flip charts, a whiteboard and comfortable chairs.
Equipment that includes flip charts, markers and a music player.
Contact Hannah de Geest, self-management coordinator hanna.degeest@hhs.iowa.gov at the Iowa HHS Diabetes Program to inquire about support for becoming a trained peer leader and starting a Better Choices, Better Health program.
