Initiating DSMES Referrals at Critical Time 1— at Diagnosis

A Guide for Communicating with Patients and Implementing Team Care. For an individual and family, the diagnosis of diabetes is often overwhelming due to fears, anger, myths and personal, family and life circumstances. Immediate care addresses these concerns through listening, providing emotional support and answering questions. Initial diabetes self-management education and support (DSMES) services at diagnosis typically include a series of visits or contacts to build on clinical, psychosocial and behavioral needs.