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Research

ADCES Diabetes Technology Research: The Role of the DCES

There's been considerable research conducted recently that offers guidance for the practicing diabetes care and education specialist working with the variety of technologies available to facilitate disease management. 

2017: A Systematic Review of Reviews Evaluating Technology-Enabled Diabetes Self-Management Education and Support

Citation: Greenwood DA, Gee PM, Fatkin KJ, Peeples M. A Systematic Review of Reviews Evaluating Technology-Enabled Diabetes Self-Management Education and Support. Journal of Diabetes Science and Technology. 2017;11(5):1015-1027. doi:10.1177/1932296817713506

2017SReviewCircle
Implications for Practice and Research: Effective technology-enabled diabetes self-management (TES) is facilitated by the TES feedback loop between a person with diabetes and their health care team. The authors identified 4 key elements and defined the TES feedback loop that contributed to an improved A1c: (1) 2-way communication, (2) PGHD analysis, (3) education, and (4) feedback. This review demonstrated that utilizing technology-enabled diabetes self-management education and support solutions significantly impacts health outcomes. Solutions with a TES feedback loop offer the greatest impact on A1c outcomes.

2020:  A Framework for Optimizing Technology-Enabled Diabetes and Cardiometabolic Care and Education.

As technology evolved, the practice of the diabetes care and education specialist expanded from health system services (ie, inpatient, outpatient, case management) to community/employer-based services (ie, weight reduction, peer coaching, health campaign programs) to remote monitoring and telehealth services to fully embrace the chronic care model.

Citation: Greenwood DA, Howell F, Scher L, et al. A Framework for Optimizing Technology-Enabled Diabetes and Cardiometabolic Care and Education: The Role of the Diabetes Care and Education Specialist. The Diabetes Educator. 2020;46(4):315-322. doi:10.1177/0145721720935125

Implications for Practice and Research: The diabetes care and education specialist is positioned to advocate for technology integration, adoption, and use of the ICC framework in practice, within organizations, and for populations.

The standardized process includes the following 3 steps: (1) Identify appropriate technologies using a shared decision-making process, (2) configure the technology and the required workflow, and (3) collaborate for ongoing interpretation and use of PGHD. The Identify-Configure-Collaborate (ICC) framework provides a standardized approach for the diabetes care and education specialist to leverage the unique skills required to identify, configure, and collaborate with the person with diabetes and care team in the initial and ongoing use of technology to improve outcomes.

2021: A New Taxonomy for Technology-Enabled Diabetes Self-Management Interventions: Results of an Umbrella Review

Citation: Greenwood DA, Litchman ML, Isaacs D, et al. A New Taxonomy for Technology-Enabled Diabetes Self-Management Interventions: Results of an Umbrella Review. Journal of Diabetes Science and Technology. August 2021. doi:10.1177/19322968211036430

This publication is an update to the 2017 umbrella review and expands the TES and ICC models to data collection supporting and informing ongoing research and understanding of the impact of diabetes technology.

TESTaxonomy
Implications for Practice and Research: Technology-enabled diabetes self-management interventions continue to be associated with improved clinical outcomes. The ongoing rapid adoption and engagement of technology makes it important to focus on uniform measures for behavioral/psychosocial outcomes to highlight healthy coping. Using the TES Taxonomy as a standard approach to describe technology-enabled interventions will support understanding of the impact technology has on diabetes outcomes.
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