Initiating DSMES Referrals at Critical Time 3—When New Complicating Factors Influence Self-Management

A Guide for Communicating with Patients and Implementing Team Care. During routine medical care, the provider may identify factors that influence treatment and the associated self-management plan. These factors may include the patient’s ability to manage and cope with diabetes complications, other health conditions, medications, physical limitations, emotional needs and basic living needs. The identification of diabetes complications or other patient factors that may influence self- management should be considered a critical indicator for diabetes education that requires immediate attention and adequate resources.