Amy Tenderich was diagnosed with type 1 diabetes in May of 2003. She is the founder and editor-in-chief of Diabetes Mine and co-authored the book Know Your Numbers, Outlive Your Diabetes. You will frequently find her speaking at diabetes, health, and social media events across the country.
Wouldn’t it be wonderful to have a personal coach for your diabetes care? Someone who would sit down with you on a regular basis to go over the important self-care tasks that keep diabetes in check: managing blood sugar, dosing medications and insulin, exercising, and understanding all the numbers involved?
In fact, there is a whole army of healthcare professionals trained to do just that. They’re called Certified Diabetes Educators, or CDEs for short. Their role is to partner with you and your family to teach diabetes self-management skills and help you gain control of your disease.
These educators work at clinics and practices across the country—which is why we encourage you to look for a doctor’s office that includes a CDE.
Why a CDE?
These coaches can help you with the everyday hurdles your doctor doesn’t have time to address.
We all know that making changes to lifelong habits (i.e. eating and exercising) can be extremely difficult. A CDE can help you create a realistic plan to gradually achieve your goals—like figuring out small diet changes that could have a big impact on your health or helping you craft a realistic plan for increasing physical activity that fits into your daily routine, considering your work, family, and other obligations.
Do be realistic: making changes (whether it’s upping your exercise or learning to calculate carbs) always takes some time until the new behavior becomes a habit. Even when seeing a CDE, you may be struggling and find that certain barriers are holding you back. The magic of the CDE is that it’s their job to help you overcome any barriers and cope better. The CDE can also pull in your family and friends and let them know how they can help you succeed in changing your behavior.
Here’s a link to help you find a CDE in your area:
Who are these educators?
A CDE can be a registered nurse, dietitian, doctor, pharmacist, or other licensed health professional. To become a CDE, the individual needs to log in several years of professional practice working with diabetic individuals and then sit for a comprehensive exam. Once a diabetes educator becomes certified, he/she is required to take ongoing courses to earn “continuing education credits” to maintain the certification. So you can expect them to be up to date on all aspects of diabetes care.
How do I get access to a CDE?
We’ve already noted that CDEs are out there, working at clinics and practices across the country. You’ll want to look for a doctor’s office that includes CDE services if possible. You can also visit many CDEs independently, simply by making an appointment with them directly. The bigger issue is who pays for it.
If you have insurance, call your insurance carrier to ask about the extent of coverage for diabetes education. Note that while diabetes education coverage is required by law in at least 45 states, some plans cover as little as two hours of counseling for the lifetime of the patient. Be sure to ask how many hours you are allotted per year.
Also: most carriers won’t accept “self-referral” to a CDE. This means that to get coverage, you’ll need a formal referral from your doctor, even if you choose to go to the CDE directly. Physicians are often so busy that they don't refer patients—but you can (and should) insist on it! If you bypass the doctor referral, you may very well forfeit insurance coverage and wind up paying hundreds of dollars out of your own pocket for each CDE session.
If you don’t have insurance, there are still some things you can do. Diabetes education sessions are often available in local community centers, churches, and hospitals, often run by professional CDEs. Especially recommended is the nationwide TCOYD (Taking Control of Your Diabetes) conference series. These are one-day diabetes education events that offer a ton of valuable information, product samples, and on-site consultation with CDEs, nutrition experts, and more. Dates and venues can be found at www.tcoyd.org.
Also be aware that new "MinuteClinic" facilities (part of CVS Caremark) located in shopping malls around the country now provide walk-in diabetes care, in addition to treatment for common everyday illnesses. You can get a blood glucose spot test and A1c screenings and talk to a pharmacist about medicine-related questions.