What is a Certified Diabetes Care and Education Specialist?

What the New Title Means and How It Affects Your Treatment

Diabetes self-management education is the cornerstone to diabetes care. Research demonstrates that working with a diabetes educator can improve outcomes for people with diabetes and prediabetes.

Diabetes educators are healthcare providers that have received education, experience, credentials, and training on all things related to diabetes, including blood glucose monitoring, medication management, meal planning, diabetes technology, proper insulin storage and administration, and management of specialist appointments, and lifestyle change. They are diabetes experts and play an integral role in creating individualized care plans for people with diabetes that considers their lifestyle, goals, beliefs, culture, and needs.

This is one of the reasons why the American Association of Diabetes Educators has rebranded themselves to now be called the Association of Diabetes Care & Education Specialists (ADCES). Based on years of research, the association discovered that a rebranding more accurately defines the role of the diabetes educator in the field.

In addition to changing the association, Certified Diabetes Educators (CDE) will now be referred to as Certified Diabetes Care and Education Specialists (CDCES). The goal of the change is to not only continue to drive optimal outcomes through the integration of diabetes education and support, but also to communicate and gain recognition of the value of the diabetes educator.

In a press release from 2020, the ADCES says, "The evidence-based rebranding process incorporated extensive qualitative and quantitative research, including interviews with 2,200 diabetes care and education specialists, people with diabetes, payers, providers and other stakeholders."

Many diabetes educators and experts would agree that this is an exciting time to be in the diabetes field. Jennifer Kartashevsky, Registered Dietitian and Certified Diabetes Educator says, "I am excited about this change. The new name CDCES, I feel, encapsulates the full scope of the certification and what we do. I am a Registered Dietitian but not all CDCES's are. Many are pharmacists, nurses, doctors, etc; the new name change reflects all that we do for people with diabetes. Our specialty expands across all areas of diabetes management."

What Does This Mean for People with Diabetes?

This title change should drive more attention to the importance of the Diabetes Care and Education Specialist as part of the medical team and hopefully increase utilization of the service. Meeting with a Diabetes Care and Education Specialist where behavioral therapy is provided and weight loss is achieved can decrease the chance of someone with prediabetes developing diabetes.

Diabetes self-management education may lower the risk of diabetes complications as well as decrease costs. It does this by reducing or eliminating medications, emergency rooms visits and helping people access cost-savings programs.

The American Diabetes Association recommends providing diabetes self-management education to all people newly diagnosed with diabetes. However, despite its value and benefit, diabetes self-management education continues to be underutilized. The hope is that this change will increase access to CDCES, and more referring doctors will acknowledge the need and value of having a CDCES as part of the treatment team. Contact your insurance provider to see if diabetes education is covered: it is covered by Medicare and most healthcare plans.

What Does This Mean for Professionals?

Certified Diabetes Care and Education Specialists are simply building on the CDE credential while also showcasing and building on the reputation of the new specialty.

Kartashevsky says, "The addition of the words, 'care' and 'specialist' better reflects our complete role. These words help to let providers and people with diabetes understand our scope and wide range of abilities. As a dietitian, it was assumed that I just provided nutrition counseling, but it has always been more than that. When I am assessing a person's treatment plan, I am looking at the whole picture. In addition to diet, I am addressing the persons' past medical history, blood pressure, body mass index, blood glucose control, if they are up to date with their appointments and if they are taking their medications as prescribed. I am also learning and identifying barriers that they have which prevents them from making necessary changes. I can address these barriers and help them navigate around them—whether they need access to insulin needles or need to learn how to download their blood sugars, I am equipped to help them will all things related to their diabetes. I consider myself more of a specialist in the area of diabetes and so I think the addition of this is great."

People who already have the credential CDE do not need to re-take the exam to be called a CDCES. However, all educators are encouraged to change their credential from CDE to CDCES and to spread the word. For those professionals who are looking to become a CDCES you can find out how that process works at the ADCES page for common CDE questions.

To accompany this new vision. the Association is committed to enhancing education and training opportunities. They are currently offering courses in technology as well as encouraging people to take advantage of webinars on obesity, and cardiovascular disease.

What Do Diabetes Care and Education Specialists Actually Do?

What you do as a Diabetes Care and Education Specialist will really depend on the setting you work in. Some CDCESs may specialize in working with children with type 1 diabetes where they play a major role in insulin adjustments and technology trainings. Other CDCEs work more adults with type 2 diabetes.

Kartashevsky works in an outpatient hospital setting in collaboration with primary care physicians, cardiologists, endocrinologists, and vascular doctors. She says, "In a typical day I am seeing people with diabetes, prediabetes, and cardiovascular disease with many different care needs regarding their diabetes management. For most of them, I am evaluating their past and present labs, body mass index, blood pressure, collecting a diet recall, reviewing blood glucose logs and continuous glucose monitor data, if available. I am also discussing any recommendations I may have pertaining to the medication regimen with their physician. Depending on the day and the site I am at, it never looks the same. Most people benefit from multiple education visits."

All Diabetes Care and Education Specialists are encouraged to work at the top of their scope. For example, many CDCEs that are also dietitians are working on teaching people with diabetes how to adjust their own insulin based on blood sugars. Because of this, many referring physicians and institutions have dietitians adjusting medications after the medical doctor has signed off on it.

Another New Focus: The Quadruple Aim

In rebranding, the Association added a new pillar of interest for Diabetes Care and Education Specialists to be part of. It is referred to as the Quadruple Aim, which is a strategic plan across health care settings in the United States that focuses on four important objectives including:

  1. The health of populations (population health)
  2. Quality of the patient’s care experience
  3. Costs associated with care
  4. Meaningfulness of the provider’s experiences

For some institutions that focus on diabetes care, this strategy is already in place. And for others, this is an important vision of the rebranding. Kartashevsky says, "The four points of focus are very consistent with current care priorities we are considering at our visits. The last addition, 'meaningfulness of the provider experience,' is a great one. It recognizes that we take pride in the care we give and get back in return."

A Word From Verywell

Diabetes is a complex chronic disease that requires people living with it to manage it daily. The value of diabetes self-management education directed by Certified Diabetes Educators is well documented. As of January 2020, Certified Diabetes Educators will now be referred to as Certified Diabetes Care and Education Specialists. The vision is to acknowledge the depth of knowledge and care that diabetes educators provide for people with diabetes and prediabetes. There is also a push to increase utilization of these services, enhance the education of providers, as well as improve the meaningfulness of the provider's experience. Coupled with continuing to integrate diabetes education, management, technology and support, this change will benefit everyone. It's time for diabetes educators to get the recognition they deserve.

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