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    • 7 hours, 10 minutes ago
      KCR likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      None of the specialists I’ve seen have suggested, recommended or prescribed methods for doing this in the lovely 40 years I’ve been T1D. My 80th birthday is the summer. It will officially be half of my life.
    • 9 hours, 8 minutes ago
      Derek West likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      I test when I have unexpected, or stubbornly high blood glucose that just won't go down. I also test when I feel sick. Testing, for me, involves putting urine on a strip, either by peeing directly or dipping the strip into urine. I may use about 2 or 3 strips in a year. When I test positive, I increase my insulin dosage to a "sick day" level, which can be anywhere from 125% dosage to 400%. I usually start with small increases in dosage, and work my way up until my blood glucose levels even out.
    • 13 hours, 43 minutes ago
      Marty likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      I test when I have unexpected, or stubbornly high blood glucose that just won't go down. I also test when I feel sick. Testing, for me, involves putting urine on a strip, either by peeing directly or dipping the strip into urine. I may use about 2 or 3 strips in a year. When I test positive, I increase my insulin dosage to a "sick day" level, which can be anywhere from 125% dosage to 400%. I usually start with small increases in dosage, and work my way up until my blood glucose levels even out.
    • 13 hours, 43 minutes ago
      Marty likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      I have a blood ketone monitor. It works just like a glucometer.
    • 15 hours, 33 minutes ago
      Kathy Hanavan likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      Perhaps only the poets who love alliteration could love the phrase, “killer ketones.” The ungodly pain experienced is your body eating and devouring itself. 🥵 Ketones are relentless killers. Do not give the bad guys a chance.
    • 15 hours, 38 minutes ago
      atr likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      I test when I have unexpected, or stubbornly high blood glucose that just won't go down. I also test when I feel sick. Testing, for me, involves putting urine on a strip, either by peeing directly or dipping the strip into urine. I may use about 2 or 3 strips in a year. When I test positive, I increase my insulin dosage to a "sick day" level, which can be anywhere from 125% dosage to 400%. I usually start with small increases in dosage, and work my way up until my blood glucose levels even out.
    • 16 hours, 14 minutes ago
      Judith Halterman likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      Perhaps only the poets who love alliteration could love the phrase, “killer ketones.” The ungodly pain experienced is your body eating and devouring itself. 🥵 Ketones are relentless killers. Do not give the bad guys a chance.
    • 1 day, 10 hours ago
      Anthony Harder likes your comment at
      Do you have ketone testing strips?
      Hi, Marty. Does your specialist have a source for that claim? It makes little sense that ketones would rise faster than BG since the metabolic pathway is much slower. If there's a source, however, I'd look further into the claim. FWIW, I've been a Type 1 for over 50 years; I can't remember the last time I tested for ketones. I possess no ketone testing strips.
    • 2 days, 12 hours ago
      Marty likes your comment at
      Does your insurance cover injectable glucagon, nasal glucagon, or both?
      Covers it with co pay
    • 2 days, 14 hours ago
      atr likes your comment at
      Does your insurance cover injectable glucagon, nasal glucagon, or both?
      It covers both. I prefer to have the the nasal version as I think it would be easier for someone else to administer.
    • 2 days, 16 hours ago
      Lawrence S. likes your comment at
      Do you have a non-expired glucagon prescription?
      I’ve been T1D for 60 years. As a child my mother didn’t like needles or injections so she just fed me when low. In college, explained use to dorm mates and classmates would’ve been a waste of time. Now married, my wife assumed the role of my mother and doesn’t like using needles on me either. I don’t have glucagon.
    • 2 days, 16 hours ago
      Lawrence S. likes your comment at
      Do you have a non-expired glucagon prescription?
      Yes, always have one or two nasal glucagon kits (Baqsimi) at home in easy to reach locations (ie at bedside and special container in living area) and always keep one with me when I go out ( along with glucose tabs or other simple carbs for treating LBS.). I apparently required injectable glucagon several times as a child and needed injectable glucagon only twice as an adult, both more than 15 years ago . More recently I needed my husband to give me Baqsimi after eating a difficult to dose for, high fat meal. The experience was terrifying so I don’t go anywhere without it now.
    • 2 days, 16 hours ago
      Lawrence S. likes your comment at
      Do you have a non-expired glucagon prescription?
      I actually have 2 non-expired prescriptions. One for Baqsimi and one for Gvoke. I have not filled either of them because they’re $500-600 each.
    • 2 days, 16 hours ago
      Lawrence S. likes your comment at
      Does your insurance cover injectable glucagon, nasal glucagon, or both?
      My Medicare Part D essentially doesn't cover glucagon when any form is nearly $500!
    • 3 days, 6 hours ago
      Amanda Barras likes your comment at
      Do you have a non-expired glucagon prescription?
      Same here. Been as low as 19 (struggling with a vacuum cleaner bag and refused to let it win) but was still able to swallow food. I did used the “red needle” as my husband refers to it once when I went low but was scheduled for surgery and couldn’t eat or drink anything. Only once in 26 years. Fortunate.
    • 4 days, 1 hour ago
      Karen Newe likes your comment at
      Share some of your favorite T1D-related books in the comments:
      Marcus Aurelius Meditations for the benefits of stoicism. Dante’s Inferno for the nine levels of diabetic hell. Kristen Lavransdatter for the benefits of suffering. And best of all, Cervantes Don Quixote for the absurdity of tilting at so many worthless windmills of frenzied diabetic activity.
    • 4 days, 14 hours ago
      Natalie Daley likes your comment at
      Share some of your favorite T1D-related books in the comments:
      Marcus Aurelius Meditations for the benefits of stoicism. Dante’s Inferno for the nine levels of diabetic hell. Kristen Lavransdatter for the benefits of suffering. And best of all, Cervantes Don Quixote for the absurdity of tilting at so many worthless windmills of frenzied diabetic activity.
    • 4 days, 15 hours ago
      atr likes your comment at
      Share some of your favorite T1D-related books in the comments:
      Marcus Aurelius Meditations for the benefits of stoicism. Dante’s Inferno for the nine levels of diabetic hell. Kristen Lavransdatter for the benefits of suffering. And best of all, Cervantes Don Quixote for the absurdity of tilting at so many worthless windmills of frenzied diabetic activity.
    • 4 days, 15 hours ago
      Lawrence S. likes your comment at
      Share some of your favorite T1D-related podcasts in the comments:
      I don't do T1 podcasts.
    • 4 days, 16 hours ago
      Lawrence S. likes your comment at
      Share some of your favorite T1D-related books in the comments:
      Marcus Aurelius Meditations for the benefits of stoicism. Dante’s Inferno for the nine levels of diabetic hell. Kristen Lavransdatter for the benefits of suffering. And best of all, Cervantes Don Quixote for the absurdity of tilting at so many worthless windmills of frenzied diabetic activity.
    • 4 days, 16 hours ago
      Gary Taylor likes your comment at
      Share some of your favorite T1D-related books in the comments:
      Marcus Aurelius Meditations for the benefits of stoicism. Dante’s Inferno for the nine levels of diabetic hell. Kristen Lavransdatter for the benefits of suffering. And best of all, Cervantes Don Quixote for the absurdity of tilting at so many worthless windmills of frenzied diabetic activity.
    • 5 days, 3 hours ago
      Amanda Barras likes your comment at
      Which T1D influencers do you enjoy following?
      Currently it’s the Diabetech, Justin Easter.
    • 5 days, 12 hours ago
      ChrisW likes your comment at
      Share some of your favorite T1D-related podcasts in the comments:
      I don't do T1 podcasts.
    • 5 days, 13 hours ago
      Kathy Hanavan likes your comment at
      Share some of your favorite T1D-related podcasts in the comments:
      TCOYD Diabetes Nerd Your Best T1D Year Think Like a Pancreas
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      Kathy Hanavan likes your comment at
      Share some of your favorite T1D-related podcasts in the comments:
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    How many times in 2022 did you have an appointment with a Certified Diabetes Care and Education Specialist?

    Home > LC Polls > How many times in 2022 did you have an appointment with a Certified Diabetes Care and Education Specialist?
    Previous

    How many times in 2022 did you get a comprehensive eye exam (including dilation with eye drops or retinal imaging) with an ophthalmologist or optometrist?

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    What have you learned about life with T1D this year?

    Sarah Howard

    Sarah Howard has worked in the diabetes research field ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange.

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    " At T1D Exchange, we’re proud to announce our Medical and Research Advisory Team — an accomplished group of leaders in endocrinology, research, and quality improvement. Together, they are redefining what’s possible in type 1 diabetes (T1D) care through rigorous data analysis, innovative research approaches, and real-world implementation. Their collective expertise is central to our mission of improving outcomes for all people living with T1D.  “We’re excited to be working with our advisors given their deep expertise across a broad range of areas in T1D,” said Dave Walton, CEO of T1D Exchange. “Their involvement magnifies our reach, knowledge, and impact. These advisors are shaping the future of diabetes care — driving innovation across research, clinical practice, and quality improvement.”    Meet the Medical & Research Advisory Team  The T1D Exchange Medical and Research Advisory Team brings together four leading endocrinologists, each offering a unique perspective and shared commitment to advancing T1D care:    Jenise Wong, MD, PhD Pediatric endocrinologist at UCSF Benioff Children’s Hospital and Professor of Pediatrics in the Division of Endocrinology at the University of California, San Francisco Focus areas: Diabetes technology adoption and usability; health equity and access to care and technology; community-based and peer-support interventions; culturally responsive care          Jennifer Sherr, MD, PhD Pediatric endocrinologist at Yale Medicine and Professor of Pediatrics in the Division of Endocrinology at Yale School of Medicine in New Haven, Connecticut Focus areas: Clinical trials in diabetes technology (CGM and AID systems), disease-modifying treatments and immunotherapies, and emerging technologies and medications, including continuous ketone monitoring and nasal glucagon     Viral Shah, MD Adult endocrinologist at Indiana University Health and Professor of Medicine in the Division of Endocrinology and Metabolism at Indiana University School of Medicine in Indianapolis, Indiana Focus areas: Diabetes technology and adjunctive therapy trials; translational and data-driven research; T1D complications and bone health         Nestoras Mathioudakis, MD, MHS Adult endocrinologist at Johns Hopkins Medicine and Associate Professor of Medicine at Johns Hopkins University School of Medicine in Baltimore, Maryland Focus areas: AI-driven clinical support tools; EMR-based data analytics for clinical decision making; data-driven quality improvement; health equity in T1D care        This accomplished team’s expertise spans adult and pediatric endocrinology, research, and quality improvement affiliated with leading institutions nationwide. Collectively, they have authored over 500 diabetes publications and secured research funding from organizations such as the National Institutes of Health, Helmsley Charitable Trust, the American Diabetes Association, and Breakthrough T1D — while remaining actively engaged in both clinical care and research.  “These individuals represent an impressive body of work while remaining deeply involved in the day-to-day realities of diabetes care,” said Walton. Their expertise covers the full spectrum of T1D care — from AI and predictive analytics to complication prevention, automated insulin delivery, continuous glucose and ketone monitoring, GLP-1 treatments, health equity, mental health, autoantibody screening, and disease prevention.    Turning insight into impact  The team’s work goes beyond research, focusing on translating insights into real-world practice. By leveraging data to scale best practices, the goal is to drive meaningful, measurable change across clinics and communities.  “Our advisors will help to extend our impact — whether through QI strategy, research innovation, funding opportunities, or new data-driven solutions,” said Walton. “We want to take what’s working at individual centers and spread that as broadly as possible.”   He added, “As a Collaborative, we’re also focused on advanced population health strategies such as exploring predictive data models to identify risks earlier and intervene before complications even begin to happen.”    The power of the T1D Exchange Quality Improvement Collaborative  Central to this work is the T1D Exchange Quality Improvement Collaborative (T1DX-QI) — a nationwide network of clinics working together to improve care through shared data, benchmarking, and evidence-based practices.  “I’m thrilled to serve as a Medical Advisor for T1D Exchange, because I’ve seen firsthand the impact this network can have on patient care,” said Dr. Nestoras Mathioudakis. “T1D Exchange is the premier organization for quality improvement in type 1 diabetes, with unparalleled assets like a large EHR database and robust patient registry.”  He added that he is excited to apply his expertise in EHR research and big data analytics to generate real-world evidence across diagnosis, management, and outcomes.  Dr. Viral Shah echoed that perspective, reflecting on T1DX-QI's evolution: “I have been involved with T1D Exchange since its early days and have had the privilege of witnessing how it has transformed the quality of diabetes care across the United States. I’m delighted to return as a Medical Advisor.”  He emphasized the importance of accelerating impact. “I look forward to working closely with the team to accelerate the evidence generation and to help translate these insights to improve patient care.”   Dr. Jenise Wong highlighted the visible impact of T1DX-QI on the delivery of care. "I’m truly honored and grateful to be working with T1D Exchange as a Medical Advisor. T1DX-QI is a remarkable resource for centers that are using continuous process improvement to improve the quality of care for people living with diabetes.”  “Diabetes centers working with T1DX –QI have done amazing work using QI methodology to make care accessible and equitable for all people with diabetes,” she said. “It’s inspiring to be a part of a collaborative in which centers have been creative and thoughtful with initiatives to address individual and systemic challenges to care, improving clinical outcomes as well as the patient experience."  Looking ahead, Dr. Sherr highlighted the opportunity to build on the existing strong foundation. “I’m very excited to be working as a Medical Advisor for T1D Exchange,” she said. “It’s a privilege to help shape what comes next for a group that’s already doing such impactful work.”  “Sharing what’s happening in clinical practice, benchmarking across centers, and understanding outcomes is how we figure out what’s working, what’s not, and where we go next,” she said.      The future of T1D care   With this team’s vision and expertise, T1D Exchange is positioned to accelerate progress in T1D care — bridging research and real-world practice to drive meaningful, measurable impact.  Together, we look forward to advancing innovation and improving outcomes for everyone affected by type 1 diabetes.   "

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    36 Comments

    1. Phyllis Biederman

      My educator has been Beverly helpful and flexible regarding her availability as needed.

      3 years ago Log in to Reply
    2. PamK

      I have never seen a Certified Diabetes Care and Education Specialist (or a CDE as they were previously called). I am not even sure if my current endocrinologist has one in the office. My previous endo did. It was me!

      2
      3 years ago Log in to Reply
    3. Robert Wilson

      In my defense. I am not an overachiever regarding appointments. I was in clinical trials 2 times in 2022. Normally 0 is my number.

      2
      3 years ago Log in to Reply
    4. Paul McGuigan

      Am one.

      3
      3 years ago Log in to Reply
    5. nyalibrarian

      We’ve seen one a lot this year, but it’s the first year of diagnosis, so I assume that number will go down a lot in following years.

      2
      3 years ago Log in to Reply
    6. AimmcG

      I answered incorrectly. I didn’t meet with an DES this year.

      3 years ago Log in to Reply
    7. Jeanne McMillan-Olson

      Was one.

      3 years ago Log in to Reply
    8. Jennifer Bounds

      3 times in 2022 I met with a Certified Diabetes Care and Education Specialist either in person or over the phone.

      3 years ago Log in to Reply
    9. AnitaS

      I used to go to one in 2019 and part of 2020 but she said unless I am having troubles I shouldn’t need to see her again as my control was very good. She is retired now, but she was an excellent CDCES and was more thorough at checking me over than most doctors. She even recommended I go to a cardiologist as my heart didn’t sound right to her. The cardiologist found an abnormallty with my heart and now I see a cardiologist and vascular surgeon on a regular basis. Luckily I am totally doing fine right now but see the heart doctors to make sure my heart stays healthy. I recommended my CDCES to a few of my diabetic relatives.

      3 years ago Log in to Reply
    10. Ms Cris

      Met with one shortly after diagnosis. Then again a year later a new CDE, but she couldn’t help me much – said that being low carb was something she couldn’t support, and my control and blood work was so good on paper there was nothing more she could recommend anyway.

      1
      3 years ago Log in to Reply
    11. rick phillips

      I switch – one quarter my doctor, the next my CDE. I have done this for years because the CDE is so accessible. When.i need something the CDE can be counted on the handle scripts etc. It’s a great arrangement.

      3 years ago Log in to Reply
      1. ConnieT1D62

        A CDE, or CDCES, cannot write RX orders unless they are also a mid-level practitioner such as a PA or NP. And not all NPs or PAs are certified as diabetes care and education specialists (CDCES).

        3 years ago Log in to Reply
    12. Marty

      Medicare requires me to see someone every 90 days so I see my endo once and my Certified Diabetes Care and Education Specialist three times per year. I’m sure she gets frustrated with me since I’m confident about managing things on my own based on >30 years of diabetes experience before I started seeing her. It’s a shame that Medicare requires me to waste her time when so many other people would really benefit from her attention.

      2
      3 years ago Log in to Reply
      1. CindyGoddard

        Totally agree with your comment.

        1
        3 years ago Log in to Reply
      2. Bea Anderson

        Medicare can be tricky. There is required and then recommended or suggested. I only comply with 90 day endo visit. Some clinics misleadingly say education is needed but certainly is not required. Unless a patient is non-compliant or incapable of managing T1. Then an office/clinic can recommend education.

        3 years ago Log in to Reply
    13. gary rind

      Saw a CDE once I started insulin but haven’t since. That was 19 years ago!

      3 years ago Log in to Reply
    14. CindyGoddard

      I visit my Diabetes Doctor who is actually a PA four times a year only because Medical requires it for my pump supplies. Otherwise I would be happy with two times a year.

      3 years ago Log in to Reply
    15. Janis Senungetuk

      Three times this year. Once with specific questions re. low potassium restrictions because of CKD dx. and twice on an alternating basis with endo appointments to satisfy Medicare rules.

      3 years ago Log in to Reply
    16. Joan Benedetto

      Virtual appointment in January, in-person visit w/PA in August. We do take advantage of My hart to request script refills in between visits.

      3 years ago Log in to Reply
      1. Joan Benedetto

        My chart

        3 years ago Log in to Reply
    17. Andrew Stewart

      Only one video appointment when I switched from Omnipod to Tandem last May.
      #BeWell

      3 years ago Log in to Reply
    18. George Lovelace

      No professional Accreditation but I like to share my Knowledge with my Endo at least 3 times a year. Having eliminated almost all hypos yet having a 5.4 A1c she enjoys my visit.

      3 years ago Log in to Reply
    19. Pauline M Reynolds

      Answered “4 times”. But don’t really know what’s the difference between a CES and the nurse practitioner I see regularly.

      3 years ago Log in to Reply
    20. Bruce Schnitzler

      Two appointments, an initial education appointment for a new insulin pump. The second for adjustments on insulin deliveries.

      3 years ago Log in to Reply
    21. Jane Cerullo

      When I was on a pump Medicare requires a visit with Endo every three months. On MDI but still see him as I now have Graves’ disease also

      3 years ago Log in to Reply
    22. Natalie Daley

      Read that too quickly — should have said never

      1
      3 years ago Log in to Reply
    23. Becky Hertz

      One with an rn (didn’t help with my question), and 2 with RD. The rd is also a sports nutrition person and has great knowledge re: fueling for sports/activity.

      3 years ago Log in to Reply
    24. Anthony Harder

      I answered zero. I see my endocrinologist 2-3 times per year and all issues are discussed then.

      3 years ago Log in to Reply
    25. ConnieT1D62

      I am a RN, MSN, CDCES myself and when I need to see one, I consult one of my fellow RN, CDCES who also live with T1D themselves. So no formal appointments within the medical system with a CDCES fir “diabetes education”. However, the endocrine NP I see as a provider is a CDCES.

      3 years ago Log in to Reply
    26. Derek West

      Only 1 , for a new pump.

      3 years ago Log in to Reply
    27. Bea Anderson

      I’ve had 3 total when first diagnosed 16 yrs ago. It wasn’t good. Then when hospitalized for kidney stone surgery they sent one in to my room, so captured. A very nice person, but knew very little about type 1 and pumps or CGM. It was a shame. She wrote down all my go to info places and a couple forums online. I do wonder how some get the job. This was Minneapolis/st Paul area, not remote area. And she wanted to know about the info. Just not part of her job requirement. 10 yrs ago, but I don’t have time for it. And of course I know there are good educators out there who are crucial to peoples care!

      3 years ago Log in to Reply
    28. Maurine Bowser

      I see an endo 3x/yr but would like to see a CDCES to have a more indepth review of insulin and carb and TIR. They are not easy, insurance wise to get into.

      3 years ago Log in to Reply
    29. Leona Hanson

      Couldn’t afford to get there it takes a day to get there and a day to get back home

      3 years ago Log in to Reply
    30. LoloMama53

      Nurse does education at Endocrinologist appointment

      3 years ago Log in to Reply
    31. Andrea Hultman

      I haven’t seen a CDE-ES since I was diagnosed 36 years ago. My endocrinology FNP is trying to get me in with a special clinic in my area just for insulin pump patients; I’m hopeful about that.

      3 years ago Log in to Reply
    32. Michael Andrews

      Participated in a Diabetes Education online group through the Clemson University Coop Health Extension. It was great and it meant that we had weekly meetings over a few months, so more meetings than in a normal year.

      3 years ago Log in to Reply

    How many times in 2022 did you have an appointment with a Certified Diabetes Care and Education Specialist? Cancel reply

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