August 6, 2014

Are CDEs the Correct Support for You?

Are certified diabetes educators the correct people to go to for support? Before I answer, there are some facts that need to be stated. The American Association of Diabetes Educators (AADE) claims 13,000 members. The Academy of Certified Diabetes Educators (ACDE) makes no claims, but declares that 18,000 have passed the National Certification Board for Diabetes Educators (NCBDE) examination.

What all organizations avoid telling us or stating includes:
Not telling us how many are retired and not working as CDEs.
How many have taken up research work and not working as CDEs.
How many are its officers in ivory towers and not working as CDEs.
How many are on book promotion tours and not working as CDEs.
How many are only working part-time as CDEs.
How many are working full-time as CDEs.

There are also others that work as CDEs and RDs and therefore not full-time as CDEs. With all this missing information it is small wonder that many of us with type 2 diabetes are not seeing or receiving any education from CDEs. This also explains why many in rural areas of the United States do not have access to CDEs as most live in highly dense population areas where they have plenty of patients.

I do not begrudge the many type 1 people as they often have greater need for CDEs than many type 2 people do. And from experience, I know that most CDEs do not want to work with type 2 people. That is not to say that type 2 people refuse to see CDEs. We do mainly because we are older and understand when we are fed mandates and mantras and are just expected to follow them. A new member in our community had classes and decided to attend, but after the first class, refused to attend the next two classes. When asked why, she said the CDE was teaching to the lowest common denominator and handing out mandates. She refused to answer the simplest of questions and only answered two questions the entire class.

When she started mandating the number of carbohydrates we should eat at every meal, one of the class members told her that a dietitian would be having a class following her class and she should stick to diabetes education and not what we should eat. Only two of the class were on insulin and those were the questions she answered. When one of the class asked about burnout and depression, she quickly pickup up her materials and said she had a patient appointment to go to and left.

The dietitian followed and would not discuss any questions and stuck to her prepared material. She was also mandating that everyone should eat a minimum number of carbohydrates per meal (55 grams minimum) and to make sure that they stayed on a low fat meal plan (no more than 10% of total calories). When a class member asked why everyone had to eat the same one-size-fits-all meal plan and could not adapt their meal plan to what worked for them, the RD said she was the instructor, had the needed education, and they were to follow her instructions. At that point most of the class got up and left.

When the person showed us the schedule and who the CDE and RD were, a few of our support group could see that they both had the titles of CDE and RD. So when many of us type 2 people see this, we understand the conflict of interest (COI) because of the support of the AADE by Big Pharma and the Academy of Nutrition and Dietetics (AND) by Big Food and Big Agriculture.

The person started asking questions of those present and we took the time to explain and answer all of his questions. Tim got his email address and said he would be sent email addresses for the rest of the members and we would try to answer most of his questions. Allen told him that a one-size-fits-all solution did not work for type 2 diabetes and that if CDEs and RDs would not properly assess his as an individual, then he was right not to attend classes.

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