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How many times in 2023 did you have an appointment with a Certified Diabetes Care and Education Specialist?
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It has been many, many years since I’ve seen a Certified Diabetes Care and Education Specialist.
7 video calls in preparation for going onto a closed loop system
@John McHenery. Congratulations, sir. I truly do hope you find ‘closed-loop’ to be of benefit to you.
Been at this for 40 years now. Not much a CDE can teach me at this point. More the reverse, actually.
haven’t seen a CDE since I started on insulin 20 years ago!
I really like my educator. She keeps me up-to-date on all of the new tech and helps communicate with the vendors and figure out insurance stuff. It’s a nice morale boast too; we review Dexcom data and talk about specific highs or lows and different techniques to try. I see my doctor every 6 months and my educator every 6 months, but we’re on a schedule so I see one of the two every quarter.
My Diabetes Care Specialist is also a Nutritionist. I have found her advice and support vital to mastering T1 since my diagnosis 2 years ago
I had appointment today wasn’t feeling good
@KIMBERELY SMITH. I hope you soon start to feel better, ma’am.
After 20+ years as a Type I, my appointments are with my endo, where I end up educating him on the latest research. Most endo’s patient population is almost exclusively Type 2 and are not as plugged into Type 1
I only see my endo twice/year. He’s been my endo for 30 years and learns from me more than I learn from him as his main interest is thyroid and his main patient population is T2 diabetics.
Many of us have the same situation.
I see a nutritionist who is a code and my doc advises my food plan
I don’t believe there are any CDEs in my ares.
I used to see a CDE exclusively until he retired. He was very well informed about diabetes technology so I always learned something during our annual visits. Now I have to see someone endo-related every 90 days in order for Medicare to cover my stuff. I hate to waste my endo’s time so I see her once per year and see her nurse practitioner 3 times per year. Her nurse practitioner focuses mostly on pump settings. After decade’s of experience, I don’t need help with that so the nurse practitioner doesn’t really know what to do with me. I’m sorry that I have to take up her time when so many other people need it more.
Put yourself in their shoes, after you are taken care of. Offer to leave early if it helps them catch up. Or talk to them about sports, weather or kids to give them a break from their daily grind of explaining fried potato products don’t count as a vegetable.
The CDE is also the CRNP or endo substitute. We see the endo once a year and the CDE CRNP twice
I clicked on 4. My PA is a CDE. My PA told me that we would be okay to go to twice a year. However,
quarterly visits are edicted by Medicare.
I am a Registered Dietitian and a Certified Diabetes Care and Education Specialist.
Me too … and when I need to consult with a CDCES I seek advice from RN or RD, CDCES colleagues who live with T1 diabetes themselves.
To clarify I am a RN, MSN, CDCES.
I’ve had three appointments with her this year. In addition to alternating with the endo every 90 days to satisfy Medicare, I asked for an appointment to discuss the low potassium restrictions because of a CKD diagnosis. She’s a tremendous help for many issues, including insurance.
I’ve seen a CDCES twice in 25 years. The first time upon diagnosis, the last setting up the Medtronic’s 670G system. (Been to 2 support/training sessions with them, swore never going back: I don’t need any one to understand how I feel, I don’t care how anyone watches me check my levels or inject, I welcome questions or comments what I can or can’t do as a dare or challenge. Heading to my first physician with the VA health system, kind of hope to stick with a general practitioner or “primary physician.” Of the 5 endocrinologists I’ve seen only 1 appeared capable to do more than handle lab work and prescriptions (thus my a1Cs below 6 doing it alone).
I had an appointment with a diabetic educator and dietician three times the first year and they were generally helpful, especially the first two appointments when every thing was new. Then I had to switch endocrinology groups and was assigned to a new educator. He is a T1d from a young age. I was looking forward to meeting him, as I thought he “got it.” It didn’t turn out so well. He really could not relate to what I was struggling with as LADA, diagnosed at 61. He seemed to have forgotten what he struggled with when newly diagnosed. He was dismissive and even somewhat condescending, though I believe not purposefully. I tried to keep a positive attitude and learn from him, but felt like I’d was wasting both our time. I cancelled the second appointment. I believe a good educator could help me. I just haven’t found the right one.
I’ll say this from my experience. 20 yrs. ago during pump training with the manufacturer rep went very well. The DE I was told to go to wore same pump, but didn’t use the features. For example, I’m at 160 well after eating. Instead of giving correction bolus or temp basal, she said I needed to go for a walk. I can’t carve out my exercise routine to take care of a high!!! That is why I wear a pump!!! Hospital DE, also gave horrible advice at first. I had to show her how I could solve all issues post surgery by myself and get great results. She wrote everything I said down and was really surprised. She asked for my resources which included a couple T1 groups at the time, books, etc. She wanted to get together after I went home, but I declined.
On doing a finger prick test? I religiously check every night before getting into bed and when the CGM readings don’t look correct & that happens at least twice after applying a new sensor in my case Dexcom 7.
After 57 years of T1D, I only see the CDE if I change insulin pump or CGM devices and need training.
My Endo changed a few years ago. At appointments, they no longer check for BG or A1C. Besides weighing me, checking BP, going over my 90 day trends on my CGM (only valuable thing) and visually looking at my infusion site areas, it is waste of time and money. My Endo actually told me I didn’t need to come in anymore and to text her if I had a question or problem.