September 16, 2015

Can Algorithms Solve Patient Diabetes Education?

I seriously doubt this. Why? Because there are too few Certified Diabetes Educators (CDEs) to effectively do this. Plus, there are too few CDEs in largely rural areas of the USA to serve the needs of these people without using telemedicine, which CDEs are presently refusing to use. Yes, reimbursement is a problem, but they even refuse to investigate or advocate further.

Linda Siminerio, RN, PhD, CDE is speaking about where she works, “I work at the University of Pittsburgh Medical Center. I am a diabetes educator and I do research in healthcare delivery systems. I am very excited to be at this meeting, where I was fortunate enough to be a part of developing a position statement on diabetes self-management education for people with type 2 diabetes. The American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics jointly published this position statement. We are very excited about this position statement because it presents all of the evidence that we have of the benefits of diabetes self-management education for people with type 2 diabetes.”

She continues that they know from the literature that diabetes self-management education works. I find that what I have been writing about the lack of diabetes education is echoed by her and she uses the term abysmally low. Yes, recent reports say that Medicare participants are only about 4 percent and for commercially insured is at a 6.8 percent. This means that the CDEs are not doing their job and providing diabetes self-management education to those needing education.

I am not surprised at another statement she makes. She says that the referral rate is particularly poor. In order for patients to receive self-management education from a trained professional, they have to have a referral from a physician. She does try to avoid the true reasons for poor referrals, by saying physicians are too busy. To this I would add that the mantras and mandates by many CDEs have caused physicians to lose trust in the CDEs. Many CDEs openly contradict what the doctor says and feel their mandates are more important than what a doctor says.

Please read my blog here about the reason I don't think there are enough CDEs to accomplish the goals put forth in the joint statement. Also consider why I don't think the ACDE professional group will be much help by opposing doctors training other people with diabetes to be peer mentors or peer to peer workers.

Then this blog about a Canadian study proving group diabetes education helps more than individual education. And the last blog I suggest is this one about the leadership of the AADE and a program I have not heard any more about for training people with diabetes to help other people with diabetes. Apparently the idea has lost favor among members of the AADE because of pressure from the ACDE.

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