Defining the Role of DSMES Nurses in Advanced Diabetes Technologies: An Expert Consensus Study with External Professional Assessment

Nurses play a central role in diabetes management and the education of people living with diabetes using advanced diabetes technologies. However, their role remains variably defined and inconsistently implemented across healthcare settings. In this study, we aim to establish expert consensus on the professional role and responsibilities, technology-related competencies and expertise, educational and leadership responsibilities, and training and organizational support of Diabetes Self-Management Education and Support (DSMES) nurses in the context of advanced diabetes technologies and to explore agreement with external professional groups. An expert consensus study was conducted with a panel of 21 expert DSMES nurses from across Spain, followed by an external professional assessment involving 306 healthcare professionals. A structured questionnaire including nine consensus statements was administered using a 5-point Likert scale. Consensus was predefined as ≥ 70% agreement. A facilitated discussion was subsequently conducted to interpret and contextualize the findings; no additional quantitative re-rating was performed. External professional assessment was conducted among nurses involved in diabetes care and endocrinologists. Descriptive statistics were used for analysis. Consensus among the expert panel was achieved for all nine statements. External professional assessment showed high levels of agreement across professional groups, with some variability regarding training requirements, leadership in DSMES, and institutional support. Nurses were recognized as key professionals in supporting the implementation, use, and self-management of advanced diabetes technologies through DSMES. Structural barriers included lack of standardized training pathways, insufficient institutional policies, and absence of formal accreditation frameworks. There is strong consensus on the essential role of DSMES nurses in the context of advanced diabetes technologies. However, the lack of standardized training and formal recognition highlights the need for competency-based educational frameworks and institutional support to ensure consistent and equitable practice. There was no patient or public contribution.