No Diabetes Educator Role for Laboratorians !

A certified diabetes educator (CDE) is a professional who is board certified to deliver education about diabetes-to the public, and especially to diabetics and their family. A CDE is supposed to be an expert on the basics of diabetes as well as the latest trends in treatment and the most recent protocols from organizations like the American Diabetes Association (ADA).

Last Saturday I attended a workshop for new diabetics. The presenter, a registered dietitian, was very personable and patient. She used a PowerPoint presentation, had life-like models of common food items and spent a great deal of time on reading food labels, as well as giving tips on preparing favorite meals in a more healthy way. I certainly got a lot from the workshop.

She was a lovely woman but some of her explanations were overly-simplistic -or just plain wrong. She claimed for instance that when the blood glucose level is too high, "your blood looks like molasses: dark and thick and struggling to move." She said cholesterol is a fat that floats on the surface of blood (really?). Also her distinction between diabetes 1 and 2 was not very clear. She essentially said Type 1 diabetes occurs in younger individuals and requires insulin; while Type 2 is brought on in older people due to poor lifestyle, but requires insulin only if it is not taken care of. That is an over simplification.

She reviewed individual laboratory results and did a fair job indicating "desirable values," but struggled when asked about issues like the values in brackets (reference intervals), difference between calculated and direct LDL as well as a definition of hemoglobin A1c. Her definition made glycated hemoglobin sound like just another chemical in the blood (like glucose) that diabetics should monitor. Again, maybe that was partly to avoid confusing a lay audience.

I noticed from the slides and her badge that she was a certified diabetes educator and that got me thinking. Wouldn't this be a great career option for a medical lab scientist (MLS)?

It seemed logical to me that with our background in physiology and biochemistry we would be a natural to explain the fundamentals of diabetes. The treatment choices could be easily learned. So could the dietary part of the program.

So I went on the website of the National Certification Board of Diabetes Educators (NCBDE) to see their eligibility requirements. I could not find route that remotely included laboratory science.

Surprise! This is not even the typical "only a doctor or nurse is qualified" claim. In addition to registered dietitians (that one makes sense), the allowable professions included pharmacist, podiatrist, occupational therapist, exercise physiologist and even social work. MLS, however, is nowhere in sight.

I have no burning desire to be a CDE myself, but I am always exploring career options to advise my laboratory colleagues who ask me for advice. I am just a little bit irked that NCBDE is bone headed enough not to think that MLS practitioners have the requisite knowledge and education to be board certified.

According to ADA statistics, there are 25.8 million diabetics in the US- 8.3 % of the population. Type 2 diabetes is growing among the young. It seems like we should be drawing on all the resources we have to ensure good, solid education of diabetics and their families.

http://community.advanceweb.com/blogs/mt_2/archive/2012/02/19/no-diabetes-educator-role-for-laboratorians.aspx

Graham