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.
