Diabetes Self-Management Education Support (DSMES)

What is DSMES?

Diabetes Self-Management Education and Support (DSMES)- A critical element of care for all people with diabetes. DSMES is the ongoing process of facilitating the knowledge, skills, and ability necessary for prediabetes and diabetes self-care as well as activities that assist a person in implementing and sustaining the behaviors needed to manage his or her condition on an ongoing basis, beyond or outside of formal self-management training.

Diabetes Care and Self Management in Montana Infographic.

Who is a Diabetes Care and Education Specialist (DCES)?

Diabetes care and education specialists are highly qualified health professionals who are experts in diabetes care and self-management education. They are an important part of your health care TEAM, and they can help you to manage your diabetes or prediabetes more easily. Research shows that diabetes care and education specialists can help you to lower your blood sugar and improve your overall health.

When should I see a diabetes care and education specialist?

There are 4 key times to see a DCES.

  1. When you are diagnosed.
  2. Annually or when you are not meeting your health goals.
  3. When you are faced with a new challenge.
  4. When there are changes in your health care or life stages.

Because your life changes over time, and so does your diabetes, partnering with a diabetes care and education specialist to positively manage your diabetes is something you can do to stay well. Ask to see a diabetes care and education specialist/diabetes care manager on a regular and ongoing basis. You'll be glad you did!

Diabetes Care and Education Visits

What happens during a diabetes care and education visit?

During diabetes education visits, a diabetes care and education specialist will spend time getting to know you and help you develop a plan that helps you overcome any barrier you are facing in managing your diabetes, develop problem-solving and coping skills, and help you develop strategies for adopting healthy behaviors.

Some examples of the many activities you may work on together are:

  • Helping you understand exactly what diabetes is and how it affects your body.
  • Explaining how diabetes medications work.
  • Figuring out what types of foods are best for you and how to plan meals that fit your life and budget.
  • Determining the best type of glucose monitoring device for your specific circumstances.
  • Suggesting apps and other technology or tools to track progress or to provide reminders.
  • Offering tips to help you cope with stress and solve problems as they arise.

Benefits of DSMES

What are the benefits of DSMES?

Being an actively engaged partner in your own diabetes care can really pay off, with improved blood sugar control, improved blood pressure and cholesterol levels, and better health in the long run. YOU are the "team captain" on your health care team!

Diabetes is a complex disease and managing it every day can be challenging. A diabetes care and education specialist can help you set priorities and coach you on each of these areas:

  • Healthy eating
  • Being active
  • Monitoring
  • Taking medication(s)
  • Problem solving
  • Reducing risks
  • Healthy coping

How do I get referred to a Diabetes Care and Education Specialist?

Diabetes Self-Management Education and Support (DSMES) is sometimes referred to as Diabetes Self-Management Training (DSMT) and is covered by Medicare, Montana Medicaid, and private insurance.

Ask your health care provider (who manages your diabetes) to refer you to a diabetes care and education specialist. Most insurance plans require a referral to an accredited DSMES program. This means that the program is recognized as a high-quality program that follows national standards and provides expertise in diabetes care and self-management education and support.

You may wish to find out how much DSMES is covered by your insurance plan. Medicare covers up to 10 hours of initial DSMES, and then 2 hours annually thereafter. Medicaid covers 3 hours of DSMES/day. Private insurance coverage of DSMES varies, so check you plan. Take full advantage of all the DSMES that your insurance offers! It's been shown that the more DSMES that you have - initially, regularly, and at key times in your life - the better you will feel and the healthier you will be.

Where do I find a DSMES program near me?

Find a Diabetes Self-Management Education and Support (DSMES) Site.

Find a DSMES Program location, directions, and contact information on this interactive map!

(Be sure to keep clicking on a city name to see all of the DSMES programs available)

What if there is not a DSMES program near me?

If you live in an area that does not have a DSMES program nearby, you might be able to receive this service virtually. Many DSMES programs offer their services via TELEHEALTH, where you meet with a Montana diabetes care and education specialist virtually, in real time. Most insurances will pay for DSMES provided via telehealth. This is a great way to get quality diabetes care and education, but not have to travel a long distance.

ASK your health care provider for a referral to DSMES and ASK if you can receive this service by telehealth visits. They will help you all along the way!

For Health Professionals:

Quality Diabetes Education Initiative (QDEI)


To find DSMES programs on our interactive map: Click here to view the DSMES Story Map!

Find a listing of all Montana Diabetes Self-Management Education and Support (DSMES) sites.

What is QDEI?

It is a program from the Montana Diabetes Program offering resources to health care professionals wanting to develop, improve or maintain their knowledge and skills regarding diabetes care and self-management education and support (DSMES). It assists both individual diabetes care and education specialists and the programs or services in which diabetes care and education is provided.

  • QDEI provides technical assistance and resources to assist outpatient settings in developing DSMES services and can assist in pursuing program accreditation so that DSMES services may be reimbursed by payers.
  • QDEI helps to increase the knowledge and skills of individual diabetes care and education specialists through a self-study and peer monitoring process tailored to the needs of the diabetes specialist, your clients, organizations, and settings.

Quality Diabetes Education Initiative Fact Sheet


All Montanans with diabetes have the knowledge, skills, and abilities to successfully self-manage their condition.


Provide a self-study and peer-mentoring program to health care professionals interested in increasing their knowledge and skills in diabetes self-management education and support and those studying to become Certified Diabetes Care and Education Specialists (CDCES).

Provide technical assistance and support to outpatient organizations developing new diabetes self-management education and support (DSMES) programs, and to those programs pursuing accreditation/recognition.


Self-Study and Peer-Mentoring Program

Options available to proceed through the self-study and peer-mentoring process:

1. Option 1 - An easy-to-understand overview book of diabetes or book focusing on type 1 diabetes:

The American Diabetes Association's "Complete Guide to Diabetes"


"Understanding Diabetes- A Handbook For People Who Are Living with Diabetes" (i.e. the "Pink Panther book" from the children's Diabetes Foundation)

2. Option 2 - A more intensive study of diabetes care and education using the following book:

"The Art and Science of Diabetes Self-Management Education and Support" (ADCES - Association of Diabetes Care and Education Specialists)

3. Option 3 - Preparing for the Certified Diabetes Care and Education Specialist (CDCES) exam. This option uses the following guidance and assistance with preparing for the exam.

"The Art and Science of Diabetes Self-Management Education and Support" (ADCES - Association of Diabetes Care and Education Specialists)

Steps in the peer mentoring program:

  1. If you are interested in providing quality, evidence-based, and engaging DSMES to persons with diabetes and their support system, and would like to participate in the mentoring program, contact the QDEI Coordinator:

Marci Butcher, RD, LN, CDCES, FADCES
Montana Diabetes Program - MT DPHHS
PO Box 6726
Helena, MT 59604
Quality Diabetes Education Initiative
Mobile: (406) 350-2658
Fax: (406) 444-7465
Email: mbutcher@midrivers.com

  1. You will be matched with a CDCES mentor. It may be the QDEI Coordinator or another CDCES, depending on the option chosen and the area in which you live.
  2. Obtain the book that accompanies the option you've chosen. There are books available from our lending library, and it is free of charge to borrow the materials.
  3. The QDEI Coordinator will facilitate contacting your mentor and you both will then make plans on how to proceed.
  4. The QDEI Coordinator will encourage you to do some self-evaluation of your current knowledge and skills, using ADCES Competencies guidelines.
  5. You and your mentor will sign a letter of agreement and return it to the QDEI Coordinator.
  6. Work through the chapters of your book, answer the post-test questions (if you are pursuing Option 1), and discuss the chapter content and any questions with your mentor.
  7. Upon completion of your option, a certificate of achievement will be awarded.

Assisting DSMES Programs with Recognition/Accreditation for obtaining reimbursement:

Contact our QDEI Coordinator for personalized technical assistance and resources for becoming a recognized/accredited DSMES program. Program accreditation/recognition is required for reimbursement of DSMES services and follow the National Standards for Diabetes Self-Management Education and Support.

Montana Quick Stats

The Montana Quick Stats provide quick access to statistics with short description on topics related to diabetes.

Additional Resources