Dr. Robert Ratner, chief scientific and
medical officer for the ADA says, “Many people with type 2
diabetes who are on medications don't need to do home glucose
monitoring at all," in talking about oral medications. Dr.
Ratner must be muttering to himself now that the joint statement by
the American Diabetes Association (ADA), The American Association of
Diabetes Educators (AADE), and The Academy of Nutrition and Dietetics
(AND) focuses primarily on type 2 diabetes.
Dr. Ratner is the person many doctors
quote when they won't recommend testing supplies and has enjoyed a
position of high esteem among these physicians. Unfortunately, he
will maintain this position because very few CDEs will be doing
education for people with type 2 diabetes. The few that may receive
education will be among the 20 to 25 percent of type 2 people using
insulin in the larger metropolitan areas.
In the conversation with my cousin
Beverly, she asked why CDEs do not teach DSME to type 2 people on
oral medication. I explained about Dr. Ratner and his statement and
that CDEs will generally not teach even self-monitoring of blood
glucose (SMBG) which is part of diabetes self-management education.
Her husband Tom asked how the support group knew so much about it. I
said because we have done our research and learned this by working
with each other. I took time to show him Alan Shanley's blogs on the
same topic and he bookmarked his blog for reading later.
Beverly said there is a lot of need for
CDEs is this area, and I agreed. I said with three community
colleges and four colleges in about an hour's drive, there is a great
need even among type 1 people. I said that there are several type 2
diabetes support groups, but I am not aware of any type 1 diabetes
support groups. Tom admitted that he felt most comfortable with our
group even with most being older them him. He said it is probably
because you accept people as they are and are not afraid to take on
any topic. I thanked him and said we have had some growing pains and
the last three weeks have been nail-biting, but we survived and now
the summer is here and we will not have any meetings until September.
I told Tom that depending on his
schedule, we could get together a few times and discuss different
issues, or we could do most of it via email. Beverly then dropped a
bomb on both of us. She said that the hospital had asked her to earn
her CDE certificate because the two nurses that had certificates were
retiring later this fall and they would be without a CDE. She said
one of them really hadn't done much CDE work for the last two years. She concluded that the hospital would pay for her additional education and testing.
I told Beverly that as long as she
could put up with my bias and not be upset with the comments I might
make, that she should go for it if she had interest in doing it.
Beverly said she had talked with the other CDE cousin that was not
talking to me and felt that it could be interesting. We talked about
the second CDE organization and I had her read a few of my blogs
about it. She said that the seemingly exclusive attitude was a
problem for her as she would be teaching a lot to Tom and she liked
the peer mentor or peer-to-peer worker ideas I had promoted. At that
point, Tom suggested that they needed to leave and they did.
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