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Who Needs a CDE?

By Karen LaVine, RN, CDE

You know that you are the only one who can control your diabetes. You already have a doctor to write your prescriptions and order your lab work. So why would you you ever need to see a Certified Diabetes Educator?

Successfully managing diabetes can be a daunting task. Even when it’s going well, the complex balancing act can seem precarious. Fortunately, there are health care professionals who can provide guidance and support, including diabetes educators. Many diabetes educators have also earned the certified diabetes educator (CDE) credential, which demonstrates distinct and specialized knowledge in the field of diabetes education. Most CDEs are registered nurses, registered dietitians, or pharmacists. So how do you determine when you might specifically need support from a CDE?

  1. At the time of the initial diagnosis: That’s when you will have the most questions and least knowledge. “Someone should be working with a CDE from the get go,” as Gary Scheiner, a certified diabetes educator who owns Integrated Diabetes Services in the Philadelphia area and wrote Think Like a Pancreas.
  2. When there is a significant change in your diabetes treatment. Like being started on a rapid acting insulin and/or carb counting, or if you will be starting to use an insulin pump.
  3. When your A1C is elevated, for example, when your A1C is more than 6.5 for type 2s or more than 7.0 for type 1s.
  4. When a doctor diagnoses a new diabetes complication.
  5. If you get a lot of hypos.
  6. When your weight increases a lot or if you have difficulty losing weight.
For more guidance, this website provides some excellent detailed recommendations. Bottom line: A diabetes educator can be helpful at numerous points along the diabetes spectrum.

So how do you go about finding a diabetes educator? Here are a few resources.

A good place to start is your primary care physician’s office. Here’s a link to a diabetes services order form that your doctor can complete to facilitate the referral process.

Searching further afield, the American Association of Diabetes Educators maintains a directory of CDEs who are available for referral. According to Sheri Wadsworth at the National Certification Board of Diabetes Educators, there currently are 15,506 certified diabetes educators in the U.S. However, some health care professionals are currently certified by the NCBDE but do not choose not to be included in the AADE referral list. Therefore, the AADE list is not complete!

A different way to find a diabetes educator is to search for diabetes education programs in your state that the American Diabetes Association recognizes.

Another referral resource is your health plan’s customer service. A staff member of a local hospital’s diabetes education department or your local pharmacist may also provide you with possible referrals.

If you are looking for diabetes education relating to a specific aspect of diabetes, Gary Scheiner says, it can be helpful to obtain referrals from health care professionals working in that specialty. For example, an insulin pump company representative who works in your area is likely to be familiar with local diabetes educators who are actively involved in insulin pump management training. A bariatric (weight loss) clinic staff member may be familiar with local diabetes educators who specialize in weight management.

Once you have identified a prospective diabetes educator, how do you determine if this person will fit your needs? “You can certainly ask them, point blank,” he says, “‘what is your top specialty?’ Don’t ask them ‘what do you do’ because they’ll say ‘everything.’ If they say their top specialty is weight control, a lot of type 1s are not going to be interested in that. And if they say their specialty is carb counting, or if they say it’s exercise, or insulin management, that’s how you find out.” Of course, good rapport, including the ability of the educator to listen and reflect accurately is also vital.

Here’s a final tip: Complete this form. Print it and share it with your diabetes educator. It can help make your visit more productive, both for you and your educator.

With the help of a diabetes educator your management of your diabetes gets a lot less daunting.

    Editor’s note: Karen graduated from nursing school and became an registered nurse (RN) in 1976. She obtained her diabetes educator certification (CDE) in 1998, and then worked as a home care nurse for 20 years. For the past four years she has worked for a disease management company.

This article originally appeared on, November 9, 2007.

Last modified: November 9, 2007

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