Last Updated: February 2024

Author: Diabetes Program, Vermont Department of Health

The Behavioral Risk Factor Surveillance System (BRFSS) question that addresses diabetes education is “have you ever taken a course or class in how to manage your diabetes yourself?” This is asked of all adults over the age of 18 years who reported having diabetes. BRFSS statewide measures for this indicator have not changed significantly over time. The peak level for this question came in 2007 with a response of 64 percent and the most recent low of 45 percent in 2017. Recent data show that the response has increased since 2017 with a recent response of 50 percent in 2022.

Diabetes self-management education is offered via different programs statewide. The State supports free evidence-based self-management workshops for all people in Vermont called My Healthy Vermont. The workshops are led by professionals or peer community members who are trained by “master trainers”. Another program offered in many areas of the state is called “diabetes self-management education/training” led exclusively by health professionals who are certified diabetes care and education specialists (DCES). These two distinct approaches to diabetes education do not duplicate efforts but rather complement each other in the information they offer. The BRFSS question about diabetes education is purposely intended to be general so that people who respond do not distinguish between the different programs.

The Vermont Department of Health partners with the Vermont Blueprint for Health to oversee administration and data reporting for the diabetes self-management programs statewide. This partnership is vital to increase participation in the My Helathy Vermont diabetes self-management program.

Diabetes education is associated with a reduction of diabetes complications associated with poor quality of life, health care costs and increased morbidity and mortality. 

All recognized or accredited diabetes education programs led by DCESs are considered by Centers for Disease Control and Prevention (CDC) to have a positive impact on outcome measures such as blood glucose control. Despite the fact that individuals with Type 2 diabetes who receive diabetes education and support by DCESs show improvement of A1C levels by as much as 1%, the programs remain underutilized in Vermont. In 2023, the Vermont Department of  Health diabetes team launched a statewide workgroup to drastically increase the number of recognized and accredited diabetes education programs in Vermont and prioritize access for poorly served populations such as people with disabilities and people of color.

The The My Healthy Vermont Workshops are also underutilized. In 2021, the Vermont Department of Health and the Vermont Blueprit for Health partnered to improve the administration of My Healthy Vermont, intensifying efforts to ensure program quality and access. Enrollment numbers have since begun to climb. Current partnerships are also focusing on provider awareness and referral strategies in addition to general promotion. and  decreases in program utilization indicates that state program staff and state partners need to do a better job promoting diabetes education options statewide. 

• Vermont Blueprint for Health
• HARK Media and Communications
• Support and Services at Home (SASH)

National data indicate that diabetes education programs are underused, so Vermont has aligned with the strategic objectives of the CDC and is leveraging funds from CDC grants to support the marketing and promotion of these diabetes education programs. 

In addition to administrating, promoting and marketing the Diabetes Prevention Program and Diabetes Self-Management Program as part of the MyHealthyVT campaign, the Vermont Department of Health diabetes team convenes the statewide Diabetes Prevention Coalition and Diabetes Self Management Education and Support Working group. Both groups take action to improve the quality and availabiity of, and access to diabetes education. In 2018, the diabetes team initiated a statewide initiative to build a network of community health workers in Vermont. A steering commitee curretnly works with health department staff to continue to build the professional identity, visibity, and practice standards of Vermont's CHWs while building systems to link them with priority populations in need of diabetes support.

Vermont tracks risk behaviors and chronic disease using a telephone survey of adults called the Behavioral Risk Factor Surveillance Survey (BRFSS). Since 1990, Vermont, along with the 49 other states, Washington D.C. and U.S. territories, has participated in the BRFSS with the Centers for Disease Control and Prevention. The CDC provides the Vermont Department of Health with funding each year to carry out the survey. Several thousand Vermonters are randomly and anonymously selected and called annually, on both landlines and cell phones. An adult (18 or older) is asked a uniform set of questions. The results are weighted to represent the adult population of the state.

Note that beginning in 2011 the CDC implemented changes to the BRFSS weighting methodology in order to more accurately represent the adult population. While this makes calculations more representative of the population, the changes in methodology also limit the ability to compare results from 2011 forward with those from previous years. The Vermont Department of Health recommends that comparisons between BRFSS data from 2011 forward and earlier years be made with caution. Statistical differences may be due to methodological changes, rather than changes in opinion or behavior.