Springer Publishing's journal Clinical Scholars Review's latest issue is all about the topic of Doctor of Nursing Practice (DNP) degrees and their role in comprehensive care. In the coming days, we will be posting several Q&A with authors whose work is published in this issue; for more, the journal can be read online here.

Providing Care across Settings for an Adult with Newly Diagnosed Diabetes Mellitus and Methicillin-resistant Staphylococcus Aureus: A Case Study

by Ella Marie Ares, DNP, ANP-BC, CDE, DCC

 What is a Certified Diabetes Educator (CDE)?

A CDE can be a Registered Nurse, a dietitian or nutritionist, pharmacist, physician, or physician’s assistant, physical or occupational therapist, exercise physiologist, or a health educator with a master’s degree, who has met certain experience requirements and has been certified by the National Certification Board of Diabetes Educators (NCBDE).

Almost 18,000 healthcare professionals hold this credential that was established by the NCBDE in 1986 to maintain the standards of Diabetes Self Management Education (http://www.ncbde.org/certification_info/what-is-a-cde/).

 Why are CDEs needed?

Diabetes Mellitus is a group of metabolic diseases requiring patients to use a number of self-care competencies to maintain stable health.  Professionals who teach patients these self-management skills themselves need a rather complex set of proficiencies, among them motivational interviewing skills, a knowledge of patient counseling and education for persons with varying levels of healthcare literacy, as well as an understanding of the underlying physiology of the disease process and its treatment.

The demand for CDEs is rapidly growing with the increasing incidence of diabetes, currently close to 2 million new cases a year (http://www.diabetes.org/diabetes-basics/statistics/).

 How have CDEs aided the patient diabetes care, in your experience?

In addition to teaching diabetes self-care management, diabetes educators assist prescribing providers with selecting and adjusting diabetes medications, and in insulin management.  Diabetes educators, with special training also instruct patients to use insulin pumps.  It takes years of experience to become effective in these diabetes care unique skills.

 Does a CDE’s role end at the hospital?

Although CDEs are often utilized in hospital settings to help evaluate inpatient insulin regimens and teach diabetes survival skills, CDEs also see patients in outpatient settings.  They can be found in diabetes specialty centers, but may also work as embedded consultants in primary care settings, or as independent consultants.  Although CDE’s have special training, each CDE is still limited to the scope of practice of their various disciplines.