January 17, 2016

Is the CDE Profession All but Done?

With all the conflicts of interest that CDEs have, it is surprising that anyone receives diabetes education. The ACDE website still has its problems and has not seen fit to correct their website. Apparently, they have many members that also have the registered dietitian title as they are offering continuing education in nutrition.

The more CDEs in both organizations expand into the registered dietitian profession, the less we need to consider them certified diabetes educators. Our support group has had some very problematic sessions with dual titled CDEs/RDs and we will not accept working with them because there is very little diabetes education and mostly faulty nutritional information. This we ignore from them and we do this because most of us use the low carb, high fat meal plans of varying degrees and we will not eat the whole grains and the number of carbohydrates they insist we consume.

In addition, the AADE is attempting to become the only group that can do diabetes education. Many people with diabetes do not like this and feel that our choices would be limited to unacceptable levels. At least some of the doctors in our area are not using them, especially if they have the dual titles. Our support group has even thanked a few of the doctors.

Many CDEs find ways to excuse themselves when depression is mentioned and this has most of us wondering why. Only one of the CDEs we have met started an assessment and then communicated with a doctor about this to have the patient taken care of properly. When this happened, we could appreciate her efforts and that fact that she did not excuse herself and leave.

We have also discovered that most CDEs want to ask about the meal plans we use. Then we are lectured about the lack of whole grains and carbohydrates we consume and that we are eating too much fat. Even though they don't go into nutrition and that we need to eat a certain number of carbohydrates, they still urge us to eat low fat and consume whole grains. And, it doesn't matter that one of the group has celiac disease, they push a one-size-fits-all way of living.

Even our honorary type 1 member has been ordered to eat whole grains and more carbohydrates and instructed to just cover them with insulin. She is the only one that she is aware of that has not gained weight during her first semester of college. All of this was stated by a CDE. Then the CDE reported this to one of the college doctors that asked her to come in for an appointment. Once at the appointment, the doctor ordered many tests and after the results, the doctor asked if she knew why she had been called for an appointment. The doctor did not wait for an answer, but explained that from the test results, he could not agree with the CDE that she would be malnourished. The doctor continued that even though she was eating low carb, high fat, her tests all showed that she was in the ranges for all of the tests and that she was not deficient in any way.

The doctor then commented that she was the first person with type 1 diabetes that he had seen that had not gained weight in their first semester and as long as she continued on her food plan, he wanted to see her on a twice a year basis to follow her progress and he felt she was doing something that he wanted to learn more about. She told the doctor she would, but felt the doctor should talk to her nutritionist who was also helping her and supply her with copies of the test result. The doctor agreed and thanked her for being willing to participate.

No comments: