Year

2026

Season

Summer

Paper Type

Doctoral Dissertation

College

Brooks College of Health

Degree Name

Doctor of Clinical Nutrition (DCN)

Department

Nutrition & Dietetics

Committee Chairperson

Casey Colin

Second Advisor

Jennifer Ross

Rights Statement

http://rightsstatements.org/vocab/InC/1.0/

Third Advisor

Lauren Butler

Department Chair

Dr. Andrea Arikawa

College Dean

Dr. Mei Zhao

Abstract

Background: Diabetes Self-Management Education (DSME) is an evidence-based intervention that improves diabetes outcomes. However, evidence on the effectiveness of DSME delivered by registered dietitians (RDs) who are also Certified Diabetes Care and Education Specialists (CDCESs) remains limited.

Objective: The aim of this study was to investigate the association of DSME provided by an RD, CDCES with changes in HbA1c, fasting blood glucose (FBG), and body mass index (BMI) in people with type 2 diabetes mellitus (T2DM).

Methods: A retrospective chart review was conducted among 437 adults with T2DM who received American Diabetes Association (ADA) recognized DSME services from an RD, CDCES in an academic medical center. Clinical outcomes, including HbA1c, FBG, and BMI, were assessed at baseline, 6 months, and 12 months. Descriptive statistics were used to describe demographic characteristics of the population. Linear mixed-effects model analyses were used for the longitudinal data to evaluate changes in the clinical outcomes over time.

Results: Linear mixed-effects analyses demonstrated significant improvements in HbA1c, FBG, and BMI over the 12-month study period following DSME delivered by the RD, CDCES (all p < 0.001). Additional analyses showed that total annual RD, CDCES contact hours were significantly associated with changes in HbA1c and FBG over time, as evidenced by significant Time × Contact Hours interactions (both p < 0.001). However, the Time × Contact Hours interaction was not significant for BMI (p = 0.109), indicating that BMI improvement over time was not significantly influenced by total annual contact hours.

Conclusion: DSME provided by an RD, CDCES was associated with significant improvements in HbA1c, FBG, and BMI among adults with T2DM. These findings support the essential role of RD, CDCESs in delivering DSME and provide evidence for expanding the integration and reimbursement of RD, CDCES-led diabetes education services.

Available for download on Wednesday, August 20, 2031

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