Abstract
More than one in seven American adults are living with diabetes (1), making the disease a leading cause of morbidity, disability, impaired quality of life, and high health care costs in the United States (1–7). Despite advances in the science of diabetes management, rates of diabetes complications remain unacceptably high, particularly among racial/ethnic minorities, low-income individuals, and residents of rural areas (1,8–10), who often have limited access to comprehensive diabetes care. Such care includes diabetes self-management education and support (DSMES), which improves diabetes knowledge, self-care behaviors, glycemic control, and quality of life, as well as reduces mortality and health care costs (11). DSMES also supports timely and effective treatment modification to achieve glycemic control, improvement of hypoglycemia awareness, and prevention of severe dysglycemia (11).
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