I’ve enjoyed reading about the recent American Association of Diabetes Educators meeting in Orlando. Wil Dubois at Diabetes Mine has written thorough recaps of many facets of the conference, and thoughtful viewpoints of the conference and of Certified Diabetes Educators in general have either been posted or will be posted at ThePerfectD and Diabetesaliciousness, as well as on blog posts I haven’t seen yet (If you’ve seen a good one, feel free to link to them in a comment below). There’s no doubt Certified Diabetes Educators do an amazing job of providing education, encouragement, and ongoing information for people living with diabetes. Metaphorically placed end to end, their numerous success stories could stretch from here to the moon and back, and probably back again. They are an important and vital part of the diabetes community.
So why haven’t I seen a CDE since my diagnosis 23 years ago?
The reasons are many. I’ll give you three right now. I’m not saying these are good reasons; in fact, they might be downright ridiculous. I’m not saying you shouldn’t see a CDE. If it will benefit you, you should. But why haven’t I seen a CDE in 23 years? It’s more than just a simple “I don’t wanna see a CDE”. Here we go:
A doctor has never asked me to see a Diabetes Educator.
This is true. I saw a Diabetes Educator in the hospital after my diagnosis. She taught me how to inject insulin, gave me the lowdown about the exchange diet (it was 1991), and she even warned me about certain parts of my anatomy not functioning properly if I didn’t take care of my diabetes (creepy, but true). Since then, not only have my GPs and endocrinologists not suggested that I see a CDE, they haven’t even mentioned it at all. Ever. I never thought about it either, until reading online about how much people love their CDEs. Since then, I’ve thought about discussing it with my endo. But as you probably know, time with our primary healthcare professionals is precious and short, so I never got around to it. But this whole paragraph makes me think: Are doctors not recommending CDEs to their patients enough? Are they only recommending them where there aren’t enough doctors or nurses in the first place? I don’t know the answers to those questions. I’m just asking.
It’s one more person to make an appointment with. And pay.
I already need to visit my endocrinologist every 90 days (no complaints about that… it just is). Then there’s my GP, whom I don’t see often, but still. I also have to keep regular appointments with the eye doctor and the podiatrist. I have to see a dermatologist every now and then. Now I need to schedule time with a CDE too? I’m already forking out over three grand per year in out-of-pocket expenses for my diabetes. Like it or love it, it’s one more appointment and one more expense.
On the other hand: If a CDE could help me get to a better state of diabetes management, they would be worth their weight in gold. Just sayin’.
Side note: I can see where people on an insurance plan that still requires referrals would just say no to this outright. Why pay an out-of-pocket expense to get a referral from the primary or endo, then pay another out-of-pocket to go see the CDE? This is why many plans have done away with the idea of referrals for everything—it’s too expensive for them too. In fact, some plans are probably saying that they won’t cover visits to a Diabetes Educator at all, though I don’t know how prevalent that is. Again, my view on that is: If it helps, it’s more than worth the cost.
It’s one more person to answer to.
This is probably the dumbest reason, and yet the easiest to write out. Why do I feel this way? Because I like my endo. I trust my endo. I want my results to make my endo happy every 90 days. If my results are less than stellar, I feel a little like I’ve let her down. I do not want that responsibility every 90 days with an additional person. To change this would probably require rewiring my brain, so I see a CDE as an additional member of my team, there to help me rather than be another person telling me what to do. But right now, while things are going okay, I’m worried that an additional person added to the mix might make me less likely to want to listen to their advice, no matter how helpful it may be.
Now… go ahead, leave a comment and give me the 1000 reasons why I’m wrong about all of this. I know I deserve it. But please be respectful. I might deserve criticism, but not hatred. Thanks.
Disclaimer: As I said above, these are NOT reasons why you should not see a CDE. Everyone has a right to seek the best help they can find.