Comments on: What Ails Diabetes Education: A Call to Action

By: camille johnson

camille johnson — Fri, 30 Nov 2007 16:09:50 +0000

Because I recently started seeing Diabetic Educators who are excellent I am now, after being T1 for 27 years, getting my diabetes under control.
One question: my educators told me that I should not mix my two types of insulin in the same syringe. Although my education was not the best, I did have ’some’ education during the past 27 years and I NEVER heard this. Nor has any other diabetic I know ever heard of this. Is it true?

By: Prudence

Prudence — Tue, 27 Nov 2007 07:28:29 +0000

Great article, Amy!

In the Philippines, there is also an “epidemic” of diabetes and what I think worsens it is the lack of education about the disease and a lot of patients are still undiagnosed, though mostly to be blamed for this is that not many people (especially the poor) can afford consult with a primary care physician, let alone a specialist. Though there are government hospitals where they could go for consult and they don’t have to pay anything, some are still stubborn not to observe close follow-up with their doctors, with the common excuse that they have to attend to more important things like survival and working to get food on the table for their family, which is understandable. It’s a complicated problem, this health care system and I believe that a good working health care system for the whole country is yet to be found.

By: Jessica Veldhuis

Jessica Veldhuis — Mon, 26 Nov 2007 05:03:37 +0000

Hi, I’m new to this site, but not to diabetes! I’ve been type 1 for almost 15 yrs. I TOTALLY agree with your recommendation that the requirements to become a CDE are less stringent. I’m a nurse and it’s my eventual goal to become a CDE, but the process is extremely daunting especially b/c I have a 1yr old and work full-time as an RN. I will be a great CDE someday though, hopefully sooner if they make it easier to get qualified!!!

By: jacque

jacque — Sun, 25 Nov 2007 02:26:53 +0000

I live in the Minneapolis area, home of the International Diabetes Center and Medtronic. Whenever I read an article that references “your diabetes team” I let out a sigh and think “oh ya.” I’ve been a type 1 for 45 years and do 5 high intensity workouts per week, running and biking. I have yet to find a CDE who has any idea about CHO gms burned per minute of exercise. We are all told to exercise, but little or nothing on the type, whens and how to incorporate exercise into our daily routines. We truly have a condition where we are in charge and the ones who need to determine what’s best for us and not rely on CDE’s or physicians. I see my endocrinologist every 6 months for 15 minutes. I have diabetes 24×7. I believe the best advice a CDE can give a newly diagnosed Type 1 is test 8-10 times a day and keep detailed logs and notes. Review them every 2 weeks to look for trends and make adjustments and repeat the above again and again.
jacque

By: Barbara

Barbara — Wed, 21 Nov 2007 02:51:15 +0000

Amy -
As one of the bloggers for the new AADE Side by Side website, I want to thank you for writing a very informative and timely article. I was one of the original diabetes educators who took the exam 21 years ago and I must say, I have found my calling. The vast majority of my peers also remain passionate about diabetes care and education, trying to improve the lives of people with diabetes. I just returned from a meeting of my colleagues and we were discussing how busy everyone was. Now I know why! We are all trying to do our share to see those 22 people a day! I would like to invite you to join us at the AADE website mydiabetespartner.org. Together we can raise our voices to improve care for those individuals living with diabetes. Thanks again and keep up the excellent work!

By: riva

riva — Tue, 20 Nov 2007 18:39:20 +0000

Everything you say, Amy, is true. And there’s another truth. CDEs are not trained to coach, but to direct. They “tell” patients what to do regardless of patients’ unique needs, environment, lifestyle. CDEs should be partnering with patients getting patients involved and willing to own responsibility for their own health. Marti Funnell and Bob Anderson are on a mission to train cdes to be partners and coaches, patients would really step up if treatment plans were customized and someone seemed to really care. Their book, The Art of Empowerment: Stories and Strategies for diabetes educators should be required reading for every cde.

By: whimsy2

whimsy2 — Tue, 20 Nov 2007 03:20:20 +0000

Your suggestions are very good, Amy — but until diabetic educators and doctors stop using the high-carb ADA recommendations as gospel, they won’t be helping diabetics gain good control. I recently read where the ADA MAY change their guidelines and downplay the current high-carb recommendations. I’ll believe it when I see it. Meanwhile, to truly help diabetics, CDEs need to stress the importance of the glycemic index and teach diabetics to avoid high GI foods. Such foods make BGs go UP. Just what diabetics don’t need.

By: baddecisionmaker

baddecisionmaker — Mon, 19 Nov 2007 21:03:22 +0000

I’m with Wil on using diabetic diabetes educators – I think with some training, we could be great resources for each other, taking advantage of all the knowledge we’ve accumulated over the years.

By: RichW

RichW — Mon, 19 Nov 2007 20:57:26 +0000

I became a Type 1 in 1984 and was hospitalized for a week to get my blood sugar stabilized and attend classes on treating diabetes. My wife and I both attended. The training seemed more than adequate.

In 1987 I saw an advertisement in Good Housekeeping about DCCT. It sounded like the Framingham Heart Study for diabetes. I was excited and called immediately (it was 11:00 PM). I got a call back the next day and made an appointment that week to visit the staff at Yale Hew Haven Hospital.

I was accepted and randomized as a member of the control group. To be honest, I was disappointed. I wanted to be part of the experimental group. As I quickly learned, it didn’t matter what group I was a part of. I learned so much about the disease and how to properly care for myself that my A1C dropped from 11.8 to 5.2 in a matter of a year. I got down to the high 4’s soon after and have been there since.

They used to tell me I was skewing the results because my A1C’s were too low. Actually they were afraid I would have a serious event. I eat more than my share of glucose tablets.

My point to all of this is that seeing a diabetes educator on a regular basis changed my life. The woman I first saw at Yale Hew Haven was in her mid 20’s and very capable. I still see her as part of the EDIC study. She’s now the study coordinator at Yale. I’ve been blessed to have her as a friend and care giver for 20 years and I hope to have 20+ more.

I wish every diabetic could say this.

By: PrintCrafter

PrintCrafter — Mon, 19 Nov 2007 20:25:00 +0000

Brovo, Amy! Your point on the barriers to becomming a CDE is a great one. At our clinic we’ve been pioneering the use of D-Folk both paid and volunteer to help with D-Ed. I think if we are to survive the epidemic we’ll need to turn to DDE’s (Diabetic Diabetes Educators) rather than CDEs.

Wil