What is a Certified Diabetes Care and Education Specialist (CDCES)?

Formerly called Certified Diabetes Educator (CDE), a Certified Diabetes Care and Education Specialist demonstrates a functional and in-depth knowledge of the diagnosis, treatment, education, and care of those living with prediabetes, diabetes, and gestational diabetes.  The credential is held by healthcare and public health professionals and recognized throughout the nation. 

Why did you want to obtain this certificate and specialize in diabetes?

My first job out of college was with the American Diabetes Association, in a position under the Community Health sector. More specifically, I worked with the families of children living with type 1 diabetes to create safe spaces for these kiddos to meet with peers who understood, on a very deep level, what their friends were living with day to day. Parents had the opportunity to support and encourage each other, and even siblings were given the space to share their feelings with other siblings of those living with type 1. It was here that I gained a very thorough understanding of just how much type 1 diabetes takes from people, from planning a day at the park to hosting an entire camp of over 150 children living with type 1, the amount of detail and preparation required for a safe experience is taxing on everyone involved. I wanted to hold some of that for these families. In part, I obtained this certificate to be a helping hand, and to take some of the weight of managing this disease off of individuals by providing individualized education, support, and oftentimes, simply a listening ear. 

My other duties within the Association included a wider community approach – making educational materials and helpful resources available to the greater population. I loved getting to chat with people and spread awareness about prediabetes and type 2 diabetes on a larger scale. But that’s all it was – putting information out there into the world, handing out pamphlets that likely ended up on the car floor. I didn’t like never seeing anyone again, or being unable to individualize the resources and education for these folks. I was repeating generalized recommendations with the intention of spreading awareness, and it wasn’t until I began working in eating disorders that I realized I may have unintentionally been spreading fear instead. In obtaining this certification, I could be the support I wanted to be for people living with prediabetes, type 2 diabetes, and gestational diabetes by focusing their care on the person first – what their specific needs and desires are in managing their diabetes.

What might be different about working with a Certified Diabetes Care and Education Specialist in private practice compared to a diabetes program through my hospital?

Hospital programs do a fantastic job of providing resources, education, and general support for those just diagnosed with diabetes. Group classes are common in these settings, and can provide a sense of community not easily found in the individual outpatient setting. Private practice, on the other hand, establishes a 1:1 relationship between you, the client, and the CDCES provider. This allows for a much more in-depth understanding of your background, lifestyle, personal barriers, preferences, and desires required for individualizing care. It’s a matter of receiving general education versus highly-specific support tailored to your unique needs. 

What are some of the topics you cover when working with someone with diabetes?

Especially upon diagnosis, it’s most important to cover topics related to safety like hypoglycemia (low blood sugar) warning signs, understanding of medication actions, and how to respond to hypo and hyperglycemia (high blood sugar). Once safety guidelines are established, we can begin to explore how your intake and movement preferences affect your diabetes day to day, as well as identify what you want in your relationship with your body, food, and activity. Intuitive Eating, the philosophy our practices bases its values off of, teaches us that we can trust what our body is telling us, and honor those cravings and needs appropriately. That concept doesn’t change just because someone has diabetes. 

What is different about disordered eating/eating disorder treatment when working with someone with diabetes? 

Diabetes or not, the purpose of ED recovery remains the same: reduce all harmful behaviors, stop the struggle and stress with food, and improve the way you feel in the body you have now. We do this by addressing the individual challenges with food, weight, exercise and body image through nutrition therapy, nutrition education, meal support and real-life experiences like restaurant outings, mindful meals, and grocery store outings. For someone living with diabetes we rely on your body’s physiological feedback (like blood glucose readings), your knowledge of diabetes, and a lot of self-compassion on the journey towards intuitive eating or whatever it is that your end goal may be. 

Does everyone with diabetes have disordered eating?

Definitely not! People with diabetes can absolutely live freely of food and body image burdens, just like those without diabetes can do. The issue lies with the teachings, mostly by medical providers, of how to safely manage diabetes or prevent your risk of diabetes should you meet some of the known risk factors. General guidelines, especially upon diagnosis, can demonize carbohydrates altogether and use scare-tactics that often result in very perfectionistic thinking. This style of thinking combined with the restriction of a food group(s) puts an individual at much greater risk of developing an eating disorder in their lifetime. A 2019 study found that disordered eating behaviors and eating disorders may affect up to 40% of people with Type 2 diabetes.   

What can people expect when working with you?

At Nutrition Instincts, we stand by person-centered, quality care. Personally, I strive to be the provider each of my clients needs me to be – sometimes that’s a friendly listening ear, other times it might be holding space for anxiety around big changes (like a diabetes diagnosis or unconditional permission to eat). Mostly, people can expect a safe space, trusting relationship, helpful tools, and a caring environment. 

Are you able to provide nutrition care for my diabetes through telehealth?

Yes! Additionally, we take HealthNet Insurance which is reimbursing for virtual visits as well

Interested in working with Maddie? Schedule a free clarity call today! 

Check out additional blogs by Maddie on the topic of diabetes and nutrition counseling:

Diabetes and Intuitive Eating

I Have Gestational Diabetes, Now What Do I do?

Three Tips for Managing Gestational Diabetes

Learn More About Our Diabetes Nutrition Therapy Services

Connect with our Registered Dietitian Nutritionists for Diabetes & Eating Disorder Therapy in San Diego

Looking to remove the guilt and shame around food and your body? Nutrition Instincts is here to help! Our team of specialized Registered Dietitian Nutritionists have expertise in eating disorders, intuitive eating, nutrition counseling for families and individuals struggling with selective eating disorders, ARFID, and picky eating, prenatal and postpartum nutrition support and diabetes therapy in San Diego and online. Learn more about our fees and insurance and answers to common questions on our FAQs page. Connect with us today to discover how to make peace with food and your body!