Riva Greenberg starts a great blog, but
then ends it by asking questions of the past AADE President Deborah
Greenwood, PhD, RN, BC-ADM, CDE and the 2016 President Hope Warshaw,
MMSc, RD, CDE, BC-ADM. Notice the multiple titles and especially the
current president of RD, CDE. The past president is an RN, CDE.
This means that the RD will be
emphasized to CDEs and other dual titles. Our support group has been
wondering if we would have more luck in 2016 to receive diabetes
education, but with this president, we do not think this will happen.
Most of our members are tired of going
to an appointment for diabetes education and not receiving education,
but nutritional advice of low fat, high carbohydrate advice, which
the insurance won't pay for when they only approved for diabetes
education. Most of us get the standard mandate of whole grains and
45 to 70 grams of carbohydrates per meal. Yet, the RD/CDEs insist
that they should be teaching nutrition. Or, they give out mandates
of getting more medication to cover the carbohydrates consumed and
they tell the doctors to up the dose of medication or add another
medication. So typical of CDEs that do not understand the value of
low carb, high fat, moderate protein food plans. This means we don't
need a higher dose of medication (insulin or oral) and do not need to
add another medication.
We have had discussions with our
insurance company and they are happy with the cost savings that have
happened of the last few years and have now accepted Suzanne and
Allison as nutritional advisers for most of us and they see the
nutritional benefits in the different test results and cost savings.
The insurance company has also allowed splitting the two hours they
require, as they know we obtain more benefits by using this method.
After several complaints about CDE/RDs
only teaching nutrition, the insurance company sends a letter that
they will only pay for diabetes education and not to submit if they
did not teach diabetes education. All CDEs have canceled when this
happens. Most know that we have our own nutritionists and that the
insurance is paying them and they don't like this and want to use up
the time when possible.
In addition, we are now asking the CDEs
to teach Self-Monitoring of Blood Glucose (SMBG). Since they do not
want to teach the importance of testing, they have told the doctors
that the ADA advises that well controlled diabetes do not need to
test, but rely only on the A1c. This is thanks to Dr. Robert Ratner,
chief scientific and medical officer for the ADA.
This is one reason we think that CDEs
need to be ignored and not allowed to give bad education in the form
of mandates, mantras, and dogma.
Now I suggest you read a blog by David Mendosa that has a different approach about CDEs and DSME. It is
different and more positive than mine is. My blog reflects what our
support group members have experienced.
Important NOTE: According the Dr. Bill Quick's website, the Academy of Certified Diabetes Educators is now defunct. Dr. Quick says this is one less cook in the kitchen. I can't say I'm sorry that this has happened. Too many things were not being covered and this leaves the AADE back in charge of CDEs, which basically means doing nothing for people with type 2 diabetes and prediabetes.
Important NOTE: According the Dr. Bill Quick's website, the Academy of Certified Diabetes Educators is now defunct. Dr. Quick says this is one less cook in the kitchen. I can't say I'm sorry that this has happened. Too many things were not being covered and this leaves the AADE back in charge of CDEs, which basically means doing nothing for people with type 2 diabetes and prediabetes.
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