Diabetes Education

System too often undervalues role of CDE.

By Nicole Johnson, MA, MPH

Over the last eight years, I have had numerous memorable moments and treasured experiences, but among the best was the day I was named an Honorary CDE by the American Association of Diabetes Educators (AADE). In fact, I was so moved that today as I finish my Master’s program in Public Health (I am a thesis away!), I am researching how to qualify as an official certified diabetes educator.

Diabetes education, in my opinion, is the most important tool in the diabetes tool kit. If a person with diabetes doesn’t have information, they cannot know how to properly manage their condition. Also it is crucial for individuals with diabetes to be re-educated often. Diabetes care changes so fast it is nearly impossible for a person living with the condition to stay on top of everything.

Recognizing the need for education, there is another need that is not often talked about amongst patients. Unless something is changed in the diabetes care system, the educators we rely on and the education we so desperately need will dwindle away and be harder to obtain.

Diabetes education and diabetes educators are at a crossroads. This specialty is threatened because of the way our health care system is organized. Our health care system is based on acute care, not prevention. What I mean is in our health care system we figuratively park ambulances at the bottom of a cliff to save survivors instead of at the top of the cliff to prevent injury.

Diabetes educators are challenged with being seen as valuable in the system and then being reimbursed for their services. Two to five diabetes education programs close each month.

Part of the problem is the restriction in reimbursement for services of diabetes education. Medicare, at this time, only covers services performed through hospital-based diabetes programs. This is unreasonable and inefficient.

CDEs should be reimbursed for all education services performed and should have the flexibility to work in any environment where need is present.

In an attempt to fix this problem, the AADE initiated legislation known as the Diabetes Self-Management Training Act. This act aims to allow CDEs to bill for service regardless of the venue. That means CDEs would have the flexibility to become more entrepreneurial and to partner with non-hospital based diabetes care programs to provide service.

This expansion of how many are educated by CDEs will undoubtedly result in a reduction in health care costs and complications. Science supports the need for this change. The Diabetes Prevention Program study found that participants at risk for type 2 diabetes who made lifestyle changes reduced their risk of getting the disease by 58 percent. All of this relates back to diabetes self-management training. As we look at our current health care challenges, especially caring for the older population, we can’t help but realize the incredible need to save health care dollars and educate the population about the benefits of prevention. If we do not take steps to reform the system and innovatively look at how we care for those on the doorstep of diabetes, we will be consumed with care and unable to service all those in need.

I encourage you to speak out about the need for diabetes educators. Talk to your elected officials and voice your concerns. Make sure your health plan/insurance company knows how much you value diabetes education. Let your educator know that he/she is important to you.

Most important, continue to fight the good fight in diabetes. Learn all you can and then turn that information into action!

Nicole Johnson
A 14-year diabetes warrior and hopeful diabetes educator

Read Nicole's bio here.

Read more of Nicole Johnson's columns.

NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.

Last Modified Date: November 27, 2012

All content on dLife.com is created and reviewed in compliance with our editorial policy.

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