American Association Of Diabetes Educators Research Articles

IJCM_130A: Self-care practices and its determinants among type 2 diabetics- A cross sectional study

Background: Self-care practices that include self-monitoring of blood sugar level, diet management, physical exercise, adherence to medications, and foot care are the cornerstones of diabetes management. Objective: To assess the self-care practices and factors associated with it among type 2 diabetics Methodology: A community-based cross-sectional study was conducted among the 150 known diabetics in a urban PHC between July 2023 and September 2023. Self-care practices among the registered diabetes patients were described in seven domains as recommended by the American Association of Diabetes Educators (AADE). Risk factors were identified using univariate, followed by multivariate logistic regression. The risk for poor self-care score was expressed in odds ratio (OR) with 95% confidence interval (CI) Results: The mean age of the participants was 57 years (SD: 9.5 years). The self-care was prominent in diet modification, physical activity, and physical activity components. The median self-care score of the participants was 14 (IQR = 12.5 to 15.5). Out of 150 diabetic patients studied, about 48 (32%) participants have good self-care scores, 96 (64%) participants have moderate self-care scores and only 6 (4%) participants have poor self- care scores. Conclusion: Our study emphasized on the need for knowledge and awareness to be provided in urban areas regarding diabetes care management and self- care practices. Structured programs need to be planned to improve the attitude and practices of diabetic patients to promote better compliance towards diet, exercise, adherence to drugs, and appropriate foot care.

EDECIDE a web-based problem-solving interventions for diabetes self-management: Protocol for a pilot clinical trial

BackgroundIn the US, diabetes affects 13.2% of African Americans, compared to 7.6% of Caucasians. Behavioral factors, such as poor diet, low physical activity, and general lack of good self-management skills and self-care knowledge are associated with poor glucose control among African Americans. African Americans are 77% more likely to develop diabetes and its associated health complications compared to non-Hispanic whites. A higher disease burden and lower adherence to self-management among this populations calls for innovative approaches to self-management training. Problem solving is a reliable tool for the behavior change necessary to improve self-management. The American Association of Diabetes Educators identifies problem-solving as one of seven core diabetes self-management behaviors. MethodsWe are using a randomized control trial design. Participants are randomized to either traditional DECIDE or eDECIDE intervention. Both interventions run bi-weekly over 18 weeks. Participant recruitment will take place through community health clinics, University health system registry, and through private clinics. The eDECIDE is an 18-week intervention designed to deliver problem-solving skills, goal setting, and education on the link between diabetes and cardiovascular disease. ConclusionThis study will provide feasibility and acceptability of the eDECIDE intervention in community populations. This pilot trial will help inform a powered full-scale study using the eDECIDE design.

Self-care practices and its determinants among diabetic population in rural Andhra Pradesh, India: A cross-sectional study

BackgroundSelf-care practice by diabetic people is key to achieving therapeutic goals. The objectives of the study were to describe the self-care practice of adult people with type 2 diabetes in a rural area of Andhra Pradesh and to identify the determinants of poor self-care practice of this population. MethodsA community-based cross-sectional study was conducted among the known diabetics in a rural PHC between November 2018 and October 2019. Self-care practices among the registered diabetes patients were described in seven domains as recommended by the American Association of Diabetes Educators (AADE). Risk factors were identified using univariate, followed by multivariate logistic regression. The risk for poor self-care score was expressed in odds ratio (OR) with 95% confidence interval (CI). ResultsA total of 727 participants were recruited for the study. The mean age of the participants was 57 years (SD: 9.5 years). The self-care was prominent in diet modification, physical activity, and physical activity components. The median self-care score of the participants was 14 (IQR = 12.5 to 15.5). 32.6% (95% CI: 31.6%–33.6%) participants had good self-care scores. With multivariate regression analysis, we found that widowed/separated (aOR 1.85, 95% CI: 1.2–3.0) was a risk factor for poor self-care scores; and skilled workers (aOR 0.28, 95% CI: 0.1–0.6) had a significantly lower risk compared to the unskilled workers. ConclusionOverall, self-care practices are poor in problem-solving, risk reduction and healthy coping behaviours. Low education and poor socio-economic status could be the most likely reasons for poor self-care practices.

Text Message Intervention for Latino Adults to Improve Diabetes Outcomes.

Introduction: Determine the effectiveness of a diabetes text message intervention to improve diabetes outcomes in Latino adults at a free clinic in the southeastern United States. Methods: A pre-post, one-group design was used with a convenience sample (n = 24) of Latino adults with type 2 diabetes and A1C ≥ 7 who consented to participate. Over 8 weeks, participants were sent 23 educational and motivational text messages that were based on the American Association of Diabetes Educators (AADE) 7 self-care tasks and the American Diabetes Association (ADA) Standards of Medical Care in Diabetes Mellitus (DM). Diabetes knowledge, self-efficacy, self-care, and A1C were measured. Results: Diabetes knowledge, self-efficacy, self-care, and A1C improved after 8 weeks. Statistically significant results (p < .05) were seen in two of the four evaluation instruments administered (Spoken Knowledge in Low Literacy in Diabetes Scale [SKILLD], p = .001, Diabetes Self-Efficacy Scale [DSES], p = .000). A1C improvements were significant (0.86 or 10 mmol/mol) from the pre-intervention (M = 9.06 [76 mmol/mol], SD = 1.49) to the post-intervention (M = 8.20 [66 mmol/mol], SD = 1.27, t [23] = 3.02, p = .006). Conclusion: Personalized communication, education, and follow-up via text messages improved diabetes knowledge, self-efficacy, self-care, and A1C among pilot project participants. Text messages are a useful tool for diabetes management.

Examining a Continuous Glucose Monitoring Plus Online Peer Support Community Intervention to Support Hispanic Adults With Type 2 Diabetes: Protocol for a Mixed Methods Feasibility Study.

BackgroundType 2 diabetes is twice as likely to affect Hispanic people than their White counterparts. Technology and social support may be an important part of behavior change. In this study, we address gaps in diabetes care for Hispanic Spanish-speaking people with diabetes through an online peer support community (OPSC) pilot intervention using Hispanic Spanish-speaking peer facilitators with diabetes to enhance the use of continuous glucose monitoring (CGM) for diabetes management.ObjectiveThis study aims to address gaps in diabetes care for Hispanic Spanish-speaking people with diabetes through an OPSC pilot intervention using Hispanic Spanish-speaking peer facilitators with diabetes to enhance the use of CGM for diabetes management.MethodsA mixed-methods, pre-post test design will be used in this feasibility study. A total of 50 Hispanic participants with type 2 diabetes willing to wear a continuous glucose monitor for 13 weeks will be recruited. Hispanic Spanish-speaking peer facilitators with diabetes and experience wearing a continuous glucose monitor will be employed and undergo training. Peer facilitators will help participants learn how CGM data can inform behavior changes via an OPSC. Participants will interact with the private OPSC at least three times a week. Weekly questions and prompts derived from the Association of Diabetes Care and Education Specialists, previously American Association of Diabetes Educators, and seven self-care behaviors will be delivered by peer facilitators to engage participants. Measures of feasibility and acceptability will be determined by the percentage of participants who enroll, complete the study, and use CGM (number of scans) and objective metrics from the OPSC. Efficacy potential outcomes include change in time in range of 70 to 180 mg/dL from baseline to 12 weeks, A1c, diabetes online community engagement, self-efficacy, and quality of life. Additionally, semistructured exit interviews will be conducted.ResultsFunding for this project was secured in November 2018 and approved by the institutional review board in April 2019. Peer facilitator recruitment and training were undertaken in the second half of 2019, with participant recruitment and data collection conducted in January and April 2020. The study has now concluded.ConclusionsThis study will generate new evidence about the use of an OPSC for Hispanic Spanish-speaking patients with diabetes to make behavior changes incorporating feedback from CGM.Trial RegistrationClinicalTrials.gov NCT03799796; https://clinicaltrials.gov/ct2/show/NCT03799796International Registered Report Identifier (IRRID)RR1-10.2196/31595

Factor of Basic Pharmacologic Therapy in DSME Applying

The objective: to investigate the influence of the scheme of basic pharmacologic therapy on the dynamics of carbohydrate and lipid metabolism in a group of patients with type 2 diabetes on the background of the use of group DSME.&#x0D; Materials and methods. The study was performed on the basis of the Department of Family Medicine and Outpatient Care within the territorial boundaries of the Kyiv agglomeration. The study included 117 patients with type 2 diabetes. The study group of patients was randomly divided into a groups of classroom training (38 people), a group of remote training (39 people) and a control group (40 people), which did not receive additional training load. Subsequently, patients from the study groups took the appropriate course in classroom (outpatient) or remote (using Skype video conferencing) formats. The education of patients methodically and meaningfully complied with the consensus recommendations of the American Diabetes Association, the American Association of Diabetes Educators and the Academy of Nutrition and Dietetics. Subsequently, the relevant indicators of diabetes were monitored at 3 and 12 months after the start of the study and the correlation of their dynamics with the basic scheme of pharmacologic therapy ts and its change during the observation period was analyzed.&#x0D; Results. During the observation period, changes in the scheme of hypoglycemic and hypolipidemic therapy were made in 10 (8,5 %) and 20 (17,0 %) patients. It should be noted that the relevant changes were bilateral, both in the direction of simplification and in the direction of intensification of drug therapy regimens. Analysis of the ratio of 3- and 12-month dynamics of carbohydrate and lipid metabolism and the scheme of hypoglycemic and hypolipidemic therapy in all study groups did not reveal a significant correlation.&#x0D; Conclusions. There is no significant correlation between the basic scheme of hypoglycemic and hypolipidemic therapy with the dynamics of carbohydrate and lipid metabolism at the stages of 3- and 12-month check-points. The lack of influence of the pharmacologic therapy scheme on the positive dynamics of diabetes mellitus emphasizes the importance of group DSME in patients with type 2 diabetes mellitus as a separate independent factor of improving of the disease.

Transforming AADE7 for Use in an Evaluation Framework for Health Information Technology in Diabetes Mellitus.

There is no validated framework to evaluate health information technology (HIT) for diabetes self-management education and support (DSMES). AADE7 Self-Care Behaviors is a patient-centered DSMES designed by the American Association of Diabetes Educators (AADE). We developed a codebook based on the AADE7 Self-Care Behaviors principles as an evaluation framework. In this commentary, we demonstrate the real-life applications of this codebook through three diabetes research studies. The first study analyzed features of mobile diabetes applications. The second study evaluated provider documentation patterns in electronic health records (EHRs) to deliver ongoing patient-centered DSMES. The third study analyzed feedback messages from diabetes apps. We found that this codebook, based on AADE7, can be instrumental as a framework for research, as well as real-life use in HIT for DSMES principles.

Self-management Education in Type 2 Diabetes in Primary Care.

Diabetes self-management education (DSME) is defined as a systematic intervention involving active participation of the individual in self-monitoring of health parameters and/or decision making using knowledge and skills. The goal of DSME is to create opportunities for people with diabetes to be informed and motivated to continuously participate in effective methods and methods of self-monitoring of diabetes. To evaluate the quality of DSME provided by primary care physicians to people with diabetes mellitus. A descriptive cross-sectional study was conducted among 120 primary care physicians. The quality of diabetes self-management training provided by physicians was assessed on a personal scale of 39 Likert questions obtained from the American Association of Diabetes Educators in seven areas of diabetes self-monitoring. The Cronbach's reliability coefficient for each domain/subscale was ≥ 0.7. The data were analysed using an independent selective t-test and one-way ANOVA. More than half of the doctors provided "inadequate quality" of diabetes self-management in all areas. Doctors had the highest average score in the domain of "drug intake" (4.46±0.61). Average scores in the "problem-solving domain" (3.52±0.63) and "being active domain" (3.46±0.75) were low. The quality of DSME provided by physicians was not related to any of the characteristics of the physician. The quality of doctors' communication on DSME in this study was suboptimal. Most adequately informed cases of diabetic behaviour associated with self-management have been associated with reduced risk factors and an orientation towards disease. Thus, training of primary care physicians in diabetic self-management is recommended because of the key role that these doctors play in managing diabetes.

Using a Do-It-Yourself Artificial Pancreas: Perspectives from Patients and Diabetes Providers

A growing number of people with diabetes are choosing to adopt do-it-yourself artificial pancreas system (DIYAPS) despite a lack of approval from the US Food and Drug Administration.We describe patients' experiences using DIYAPS, and patient and diabetes providers' perspectives on the use of such technology. We distributed surveys to patients and diabetes providers to assess each group's perspectives on the use of DIYAPS. The patient survey also assessed glycemic control and impact on sleep. The patient survey was distributed in February 2019 via Facebook and Twitter (n = 101). The provider survey was distributed via the American Association of Diabetes Educators' e-mail newsletter in April 2019 and the Pediatric Endocrine Society membership e-mail list in May 2019 (n = 152). Patients overwhelmingly described improvements in glycemic control and sleep quality: 94% reported improvement in time in range, and 64% reported improvement in all five areas assessed. Eighty-nine percent of patients described DIYAPS as "Safe" or "Very Safe," compared to only 27% of providers. Most felt encouraged by their diabetes provider to continue using DIYAPS, but few described providers as knowledgeable regarding its use. Providers cited a lack of experience with such systems and an inability to troubleshoot them as their most significant challenges. Despite evidence that DIYAPS usage is increasing, our surveys suggest that patients' adoption of this technology and trust in it is outpacing that of diabetes providers. Providers must be aware of this growing population of patients and familiarize themselves with DIYAPS to support patients using this technology.

Implications of diabetes self-management education in metabolic control

Diabetes is a chronic, progressive and disabling disease that affects millions of people around the world, with a high mortality rate derived from poor control. The paradigm of the treatment of diabetes has shifted to focus on empowering the person with diabetes to manage the disease successfully and to improve their quality of life. Diabetes self-management education, or DSME, is a process where people with diabetes gain the knowledge and skills needed to make informed decisions, modify their behaviour and to self-manage, in collaboration with health personnel, successfully the disease and its related conditions. To achieve these goals a structured educational program is used, in 4 stages which include assessment, planning, implementation and evaluation; to carry on this program, the model of the seven self-care behaviours known as AADE7®, developed by the American Association of Diabetes Educators, is used as a frame of reference. The objective of this paper is to analyse the components of the education program for diabetes self-care as well as its reference framework, the AADE7® model, and its importance in the metabolic control of diabetes.

Team clinic: Expansion of a multidisciplinary care model for adolescents with type 1 diabetes

BackgroundAdolescent and young adults (AYA) with Type 1 Diabetes (T1D) experience more difficulty with glycemic control than patients in all other age groups. The shared medical appointment (SMA) model has been effective in multiple healthcare populations, but the feasibility and effectiveness of SMA in AYA patients with T1D is unclear. MethodsThis research leverages the team's multidisciplinary expertise to develop an engaging intervention toolkit and test the implementation of the Team Clinic care model for the treatment of T1D among middle school adolescents in a large urban children's hospital serving an economically, racially and ethnically diverse population. In Phase 1, the team will manualize the Team Clinic care model into an engaging, age-appropriate educational and intervention toolkit. In Phase 2, the team will conduct a randomized clinical trial to test the feasibility and usability of the toolkit from the provider perspective (team member satisfaction; clinical efficiency; compliance with American Diabetes Association, American Association of Diabetes Educators, and California Children's Services standards; and payor-level cost data) and the preliminary efficacy of the intervention toolkit on patient- and family-level outcomes (attendance, acceptability/satisfaction with care, patient-level cost data, diabetes outcomes, diabetes family conflict, diabetes distress, and depression). DiscussionAYA patients with T1D often receive care in clinics and institutions with limited resources and time. This research tests the feasibility and efficacy of an innovative and potentially cost-effective SMA model to address the unique needs of underserved populations, while meeting national and state clinical standards.Trial registrationThe study is registered with ClinicalTrials.gov (Protocol Record: NCT04190368).

An Effective Model of Diabetes Care and Education: Revising the AADE7 Self-Care Behaviors®.

The AADE7 Self-Care Behaviors® (AADE7) is a robust framework for self-management of diabetes and other related conditions, such as prediabetes and cardiometabolic diseases. It is the position of the American Association of Diabetes Educators (AADE) that, at the cornerstone of diabetes self-management education and support, the AADE7 is the framework for achieving behavior change that leads to effective self-management through improved behavior and clinical outcome measures. The AADE7 model guides the health care team in effective person-centered collaboration and goal setting to achieve health-related outcomes and improved quality of life. Continued research and evidence are critical to expand this model and broaden its application to other chronic conditions. Given the advances in the science of diabetes management, as well as in diabetes self-management education and support, AADE has evaluated the AADE7 within the framework of these advances, including the digital and dynamic health care landscape. This revised position statement blends the updates in research and AADE's vision and expansion beyond diabetes to refresh the AADE7 framework. This revision reflects the perspectives of all members of the health care team as they problem solve with individuals who are at risk for or who have diabetes and related conditions to achieve healthier outcomes.

EVALUATION OF DIABETES SELF-MANAGEMENT EDUCATION IN PATIENTS WITH CONCOMITANT CHRONIC KIDNEY DISEASE

The aim: Was to evaluate the quality of DSME provided by primary care physicians to people with diabetes mellitus. Materials and methods: A descriptive cross-sectional study was conducted among 120 primary care physicians. The quality of diabetes self-management training provided by physicians was assessed on a personal scale of 39 Likert questions obtained from the American Association of Diabetes Educators in seven areas of diabetes self-monitoring. The Cronbach's reliability coefficient for each domain / subscale was ≥ 0.7. The data were analyzed using an independent selective t-test and one-way ANOVA. Results: More than half of the doctors provided "inadequate quality" of diabetes self-management in all areas. Doctors had the highest average score in the domain of "drug intake" (4.46 ± 0.61). Average scores in the "problem-solving domain" (3.52 ± 0.63) and " being active domain" (3.46 ± 0.75) were low. The quality of DSME provided by physicians was not related to any of the characteristics of the physician. Conclusions: The quality of doctors' communication on DSME in this study was suboptimal. Most adequately informed cases of diabetic behavior associated with self-management have been associated with reduced risk factors and an orientation towards disease. Thus, training of primary care physicians in diabetic self-management is recommended because of the key role that these doctors play in managing diabetes.

Diabetes self-management education exposure and glycated haemoglobin levels among Marshallese participants in a randomized controlled study.

A randomized control trial (RCT) of diabetes self-management education (DSME), undertaken by a community-based participatory research (CBPR) partnership between the University of Arkansas for Medical Sciences (UAMS) and the Marshallese community in Arkansas. The RCT examined the effect of hours of intervention exposure, with the hypothesis that increased exposure is one reason the Adapted-Family DSME was found to be more effective than the Standard DSME. Some 221 Marshallese with type 2 diabetes were randomized to an Adapted-Family DSME group (in-home setting) (n=110) or a Standard DMSE group (community setting) (n=111). The Adapted-Family DSME included 10h of education that covered the core self-care elements recommended by the American Diabetes Association (ADA) and American Association of Diabetes Educators' (AADE) recommendations. The Standard DSME included 10h of intervention with all ADA and AADE core elements. The number of hours of intervention exposure in the Adapted-Family DSME arm (mean=8.0; median=10.0) was significantly higher than the number of hours of intervention received in the Standard DSME arm (mean=1.5; median=0.0). As hypothesized, higher exposure was associated with a significant reduction in HbA1c in a model including only study arm and exposure (P=0.01), and in a model including study arm, exposure, and all demographic variables (P=0.046). This finding is consistent with previous reviews that showed increased exposure to DSME produced improved glycaemic control and ≥10h of DSME produces clinically meaningful reductions in HbA1c .

696-P: The CDC Web-Based Diabetes Self-Management Education and Support Toolkit

Diabetes self-management education and support (DSMES) provides an evidence-based approach to empower people with diabetes to navigate self-management decisions and activities, and has been shown to improve health outcomes. Despite the evidence that DSMES services are cost-effective and have a positive impact on diabetes-related outcomes, they are underutilized. To address this problem, the Centers for Disease Control and Prevention (CDC) developed a DSMES toolkit to increase access to and participation in DSMES services among people with diabetes and to promote health care provider referrals. The toolkit explains the process for securing recognition or accreditation of DSMES services. It offers resources to assist in maximizing reimbursement, eliminating barriers to participation, and linking DSMES to quality measures. The toolkit suggests improving access to DSMES through shared medical appointments, pharmacies, and telehealth. It describes the four critical times to refer persons to DSMES and provides tools to assist with making referrals. National experts from the American Diabetes Association and the American Association of Diabetes Educators, certified diabetes educators (CDE), and public health professionals informed the content of the toolkit. Participants from six state health departments; three DSMES services (pharmacy, federally qualified health center, local health department); and experts from the CDC (pharmacist CDE, nurse diabetes educator, project officer, endocrinologist) tested the toolkit and found it easy to use with relevant information that will be helpful in addressing barriers and challenges to improving access to and participation in DSMES. Expanded use of and referrals to DSMES can help ensure that people with diabetes receive the support they need to successfully manage their diabetes and prevent or delay serious and costly complications. The DSMES toolkit can assist diabetes and public health professionals in working together to address underuse of DSMES. Disclosure J. Houston: None. L.E. Edwards: None.

53-LB: Availability of Diabetes Self-Management Education and Support Programs in United States Counties

Authors developed an interactive map visualizing county level availability of Diabetes Self-Management Education and Support (DSMES) site or program locations. Location data were overlaid with diabetes prevalence data and socio-economic status data. Over 4200 locations were geocoded including 3471 sites (American Diabetes Association recognized) and 802 program locations (American Association of Diabetes Educators accredited). Counties were characterized as having or not having DSMES class locations. Counties were additionally characterized based on tertiles of diabetes prevalence and socio-economic disadvantage (using the Area Deprivation Index (ADI) score). This analysis showed that 48 percent of U.S. counties (1515/3142 counties and county equivalents) had a DSMES program with at least one site or program location. Approximately 39% of counties in the highest diabetes prevalence tertile (greatest diabetes burden) had DSMES programs compared to 53% in the middle tertile of diabetes prevalence and 54% in the lowest tertile of diabetes prevalence. Approximately 26% of counties in the tertile with highest ADI scores (representing greatest socio-economic disadvantage) had DSMES programs compared to 48% in the middle tertile and 69% percent in the tertile with the lowest ADI scores (least socio-economic disadvantage). This interactive map is a tool that can be used at a national level and by state and local health departments and others to prioritize establishment and expansion of programs in underserved counties with higher rates of diabetes prevalence and greater socio-economic disadvantage. Disclosure B. Jayapaul-Philip: None. S. Dai: None. E. Woghiren: None. G.E. Rutledge: None.

Predictors of Health-Protective Behavior and Glycemia After Gestational Diabetes, NHANES 2007-2014.

This study examined weight loss behavior and the prevalence of hyperglycemia unawareness (unknown high blood glucose) after gestational diabetes mellitus (GDM), within a nationally, representative sample. This study also examined social-demographic, psychosocial, provider communication, and health care access/utilization factors as predictors of A1C and health-protective behavior after GDM. A secondary analysis of 2007-2014 National Health and Nutrition Examination Surveys (NHANES) data was conducted, including 205 women, aged 20 to 44 years, with a history of GDM, whose last live birth was in the past 10 years, excluding pregnant women and those with diabetes. Weighted bivariate, stepwise linear, and binary logistic regression analyses were conducted to examine correlates of A1C, weight change, weight loss attempt and behavior, diabetes screening, and physical activity. Hyperglycemia unawareness was associated with increased A1C and weight gain in the past year. Personal weight loss goal and perception of overweight increased the odds of weight loss attempt. Depressive symptoms were associated with weight gain over the past year. A third of the sample failed to have their glucose tested in the past 3 years. Two-thirds were never told about their personal risk for diabetes, but provider communication increased the odds of meeting weekly activity recommendations and glucose screening. Hispanic women and non-Hispanic black women were less likely to have had glucose screening than non-Hispanic white women. Diabetes educators should address gaps in provider communication, while supporting psychosocial needs and reducing disparities to encourage health-protective behavior after GDM. The American Association of Diabetes Educators, 7 Self-Care Behaviors (AADE-7TM) provides an excellent framework for interventions to support health-protective behavior after GDM.

A New Paediatric Diabetes Knowledge Test - M-WIKAD Development and Factor Analysis.

Purpose: The purpose of this study was to develop a measure of type 1 diabetes mellitus (T1DM) knowledge that is aimed at youth and is based on contemporary management standards. Methods: An 88-item test was derived from the American Association of Diabetes Educators 7 Self-Care Behaviors. Results: A multidisciplinary team selected the best 49 items which were piloted in a sample of 119 youths (59 males, aged 12–18, having a mean ± standard deviation glycated haemoglobin (A1C) of 9.9%±1.80 (84.7±19.7 mmol/mol). A minimum absolute point-biserial correlation coefficient of 0.250 was used to choose 49 items from the original 88 questions. Categorical principal component analysis was then used to identify the best factor analytical model that consisted of five factors composed of 19 items. These five factors explained 57% of item variances. Factors were associated with the latent variables: advanced problem-solving, hypoglycaemia prevention and management, taking insulin/medication administration, daily management and healthy active living. Conclusion: A new T1D knowledge test for youth was refined from 88 to 49 questions based on expert opinion and empirical test construction. The instrument was then refined to 19 items based on exploratory factor analysis. Future goals are to validate this factor model with another cohort and confirm concurrent validity based on youth’s glycated haemoglobin and adherence behaviours. Our new T1DM knowledge measure initially appears valid and promising as a new clinical and research tool.

Role of the Diabetes Educator in Inpatient Diabetes Management.

It is the position of American Association of Diabetes Educators (AADE) that all inpatient interdisciplinary teams include a diabetes educator to lead or support improvement efforts that affect patients hospitalized with diabetes or hyperglycemia. This not only encompasses patient and family education but education of interdisciplinary team members and achievement of diabetes-related organizational quality metrics and performance outcomes.

The Role of the Diabetes Educator in Diabetes Formulary and Medical Device Decisions.

It is the position of the American Association of Diabetes Educators that diabetes educators should be included as expert consultants for formulary decisions regarding diabetes medications and medical devices.