Recently I had the privilege of being a featured guest on “The Mother Love” radio broadcast on ”latalkradio”. Mother Love and I continue to work together on the dLife TV show. She is a co-host and I am a contributing medical producer (and member of the dLife medical advisory board). It is a remarkable show and I am honored to be associated with people who are so passionate about finding a cure for diabetes, and offering helpful advise for those who have this challenging disease. So when Mother Love asked me to talk about being a Certified Diabetes Educator (CDE), I was very excited to share my experiences.
After I became a Registered Dietitian and completed my Masters of Science degree in applied physiology and nutrition at Columbia University in New York, I became intensely interested in the treatment of diabetes. Going back 20 plus years ago, diabetes was not in the news the way it is today. There was no discussion of pre-diabetes (or “pre-type 2 diabetes). In those days people talked about childhood or juvenile diabetes vs adult diabetes. We now know about the pre-diabetes epidemic, gestational diabetes, as well as Type 1 and Type 2 diabetes. When I began my private practice, I saw the need to educate people and their families on how to live with diabetes (and manage their blood sugars). So, I decided to become a Certified Diabetes Educator!
According to the National Certification Board for Diabetes Educators (www.ncbde.org/eligibility.cfm), in order to even “apply” to take the CDE (Certified Diabetes Educator) exam, you must be licensed and registered as a health educator for a specific period of time in one of the following areas; clinical psychology, registered nursing, occupational therapy, optometry, pharmacy, physical therapy, physician, podiatry, registered dietitian, physician’s assistant as well as a few other health professions. Additionally, you must have two years experience in diabetes self-management education, including 1,000 hours in diabetes education! Before taking the test you must also be currently working in the field of diabetes education at least four hours per week. In order to maintain the CDE credential, one must participate in 75 hours of continuing education (specific to the study of diabetes) every five years. These intense credentials define why a CDE is the true diabetes expert.
I pride myself on really listening to all of my patients’ needs. Before meeting for an initial visit, I ask a new patient to complete a “health assessment” form. The form includes details about the individual’s medical and nutritional history, as well current medications or supplements, physical activity level and other relevant information. People are often anxious before seeing a new health professional, and the information “intake” can be overwhelming. I pride myself on allowing my patients to feel comfortable and relaxed when working with me. Having this vital medical and lifestyle information prior to meeting with a new patient allows me spend more time counseling and less time gathering data. I encourage families to become involved when appropriate. We also include the patient’s physician and other health care professionals in our care plan (as this should be a supportive team effort).
Once we start working “together”, everything about diabetes management is discussed. My practice focuses primarily on a nutritional care and exercise plan. We also discuss medication compliance and overall improved emotional health and well being. Developing a nutritional care plan is a collaborative effort. Your diet plan should not be overly restrictive and difficult to follow. If I told you to only eat dry fish and dark green vegetables all day, every day, you’d run out of my office! So it’s important to work together to make “lifestyle changes” that will improve blood sugar control, while allowing long term compliance (in the real world). Only after I learn a little more about a person (and their lifestyle), can we start to amend and tweak what they eat. We pay special attention to carbohydrate consumption, and eventually manage blood sugar levels. Our goals can be somewhat varied. But basically, everyone wants to improve their blood sugars to prevent all of the long term problems that are associated with poor blood glucose management. Sometimes goals include weight control, increased physical activity and portion control. But everyone wants to live a long healthy life, without developing problems related to high blood sugar (such as diseases of the eyes, kidney and heart).
If you know someone who would benefit from working with a Registered Dietitian who is also a Certified Diabetes Educator, please check out the NCBDE website (www.ncbde.org). We truly are the diabetes experts!
