(4) Foundations of care: education, nutrition, physical activity, smoking cessation, psychosocial care, and immunization.

Recommendations c People with diabetes should receive diabetes self-management education (DSME) and diabetes self-management support (DSMS) according to the national standards for DSME and DSMS when their diabetes is diagnosed and as needed thereafter. B c Effective self-management and quality of life are the key outcomes of DSME and DSMS and should be measured and monitored as part of care. C c DSME and DSMS should address psychosocial issues, as emotional well-being is associated with positive diabetes outcomes. C c DSME and DSMS programs are appropriate venues for people with prediabetes to receive education and support to develop and maintain behaviors that can prevent or delay the onset of diabetes. C c Because DSME and DSMS can result in cost-savings and improved outcomes B, DSME and DSMS should be adequately reimbursed by third-party payers. E