This Is AuburnElectronic Theses and Dissertations

The Efficacy of a Diabetes Self-Management Education and Support Coaching Program for the Ongoing Management of Type 2 Diabetes in North Alabama




Stanley Chester, Brittannie

Type of Degree

PhD Dissertation


Nutrition, Dietetics and Hospitality Management


According to the latest 2020 National Diabetes Statistics Report from the Centers for Disease Control and Prevention, 34.2 million people have diabetes in the United States (10.5% of the population).1 This number has increased since the 2017.2 Type 2 diabetes accounts for about 90 to 95 percent of all diagnosed cases of diabetes in adults. Diabetes self-management education and support (DSMES) and medical nutrition therapy (MNT) have been proven to improve patient outcomes. After a diabetes diagnosis, physicians can refer their patients to Registered Dietitians (RD) that provide DSMES regularly. Combining the knowledge of the physician and RD can help patients to reach optimal blood glucose control in order to prevent or minimize complications. However, many patients rely on their physician solely for diabetes education despite referrals for education outside of the physician’s office. If they do see a RD, it’s only twice a year (every 6 months) due to insurance coverage limits. Huntsville Hospital provides a special coaching program for employees with diabetes called Health Matters. They are provided with DSMES quarterly by a RD, in addition to lab work to track their progress. Using retroactive data collection, we analyzed the health outcomes of the patients in this coaching program, in hopes of this program becoming a standard for managing type 2 diabetes long-term. The data were collected from Huntsville Hospital's electronic medical records via CliniPro electronic health system. One-way analysis of variance was used to calculate the difference between three or more than three group analyses with Tukey post-hoc test. The repeated measures of ANOVA were carried out to determine the significance between different time points of the DSMES program in each group analysis. iii Coaching through Health Matters led to participants achieving and/or maintaining an A1C near the target of 7%. While there were no significant improvements in health outcomes overall, the ongoing DSMES program significantly improved the A1C in participants with uncontrolled diabetes, A1C >9%. These diabetes management changes could help decrease the risk of complications and improve patients’ quality of life. The findings from this research will be used to further explore the effects of DSMES and the importance of more frequent ongoing DSMES.