Assessment of diabetes self-management education guideline content across Spanish regions: a document-based comparative analysis.

Abstract

OBJECTIVE: This study aims to evaluate the content, structure, and alignment with international standards of Diabetes Self-Management Education guidelines across Spain's regional healthcare systems. It focuses on comparing the guidelines and documents used in these programs against international standards to identify key patterns, disparities, and areas for improvement. METHODS: The study employed a comparative descriptive analysis, systematically reviewing and contrasting 13 relevant documents from the Spanish Ministry of Health and regional health authorities. The evaluation was based on international standards for DSME, set by the American Diabetes Association and the Global Diabetes Survey. Key aspects assessed included program structure, target population, content delivery, healthcare provider involvement, and quality management. RESULTS: The results revealed significant variability in the DSME guidelines, with most emphasising individualised education and a multidisciplinary approach. However, there were gaps in addressing psychosocial factors, dietary support and the inclusion of vulnerable populations. Additionally, quality management and evaluation processes were inconsistently described, with some regional guidelines lacking systematic assessment frameworks. CONCLUSION: The study highlights the need for harmonising DSME guidelines across Spain. It recommends improving inclusivity, psychosocial support, multidisciplinary involvement, quality monitoring, and digital delivery to strengthen diabetes education and reduce regional inequalities nationwide.