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Individualised diabetes self-management education and support (DSMES) is essential in ensuring the effectiveness of all aspects of diabetes care. DSMES may be provided to individuals or in group sessions and should be offered:
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At diagnosis
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Annually
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On development of complications
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Following transitions in life and in care
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DSMES should be culturally appropriate and ideally involve whānau providing both discussion and written information on:
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Living well with diabetes such as diabetes and healthy food choices, diabetes and physical activity, staying well with diabetes etc.
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Pathophysiology of diabetes and treatment options
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Prevention, monitoring and treatment of diabetic complications
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Sick day management, how to self-monitor blood glucose and capillary levels when appropriate, and how to manage hypoglycaemia if on insulin and/or sulfonylureas
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Diabetes and driving
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Consider referral to culturally appropriate services (e.g. Kaupapa Māori services) if available
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Consider referral for psychology input if ongoing significant diabetes distress
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Patients may find community support groups (such as Diabetes New Zealand) and technological adjuncts (such as mobile apps) beneficial