When I was diagnosed as type 2 back in 1990 I received excellent education on the disease, how to best achieve better blood glucose management, the risks of poor BG management and there was a sense of cohesiveness between the medical professionals. I was lucky that all of them were in the same clinic with access to all my records. This is no longer true.
Over on the Beyond Type 2 site there is a question, What is one thing you wish someone told you when you were diagnosed? #NewlyDiagnosed
Some of the responses indicate that there is a real need for everyone who is diagnosed with any type of diabetes mellitus to have access to competent diabetes education. In my area the only CDE is part of an organization that no longer takes my insurance. There are not others, even though there are many diabetics in this region.
I was thinking that CDEs could not only hold classes for patients, but also do continuing ed for medical staff. Many are just ignorant. Their ignorance is harming patients, from PCPs, to ER and hospitalization.
From one of our large hospital systems there are two links,
Living Well With Diabetes and Diabetes Management Classes When clicked I get this - The page you requested can not be found This has been the same for several years.
When I was diagnosed there was a local chapter of the American Diabetes Association, no longer. Yet diabetes, especially type 2 is increasing exponentially.
I find it sad that as a patient am more knowledgeable than the medical professionals I am in contact with. And I am fully aware that I have holes in my knowledge.
So, is what I am seeing here in south central Texas true elsewhere?
Yes, I think it is the same everywhere, even in NY. There are CDEs at my clinic but in my opinion, the ones I’ve seen lack the latest knowledge. For example, one told me I should eat something prior to exercising to raise my BG to 200mg/dL. If I did that, I would not have the energy to run! This was probably 5 years or so ago, but due to that advice I hesitate to see any of the clinic’s CDEs.
This is a major problem in many areas. Same holds for endos. It was something we thought about when we moved to San Diego. What kind of medical care is available? Thankfully, we were super lucky to not only have great medical facilities but great research options. I do think that online zoom options might be the best way for people in medical deserts. Good luck finding someone. It is going to get harder and harder to find medical care as more and more people are leaving the field.
It’s everywhere in the US. It’s worse for “endocrinologists”. There are only 6000 for ~30 million (10% insulin-using) persons with diabetes. Half those doctors are over age 55, and the 220,000 PCPs are far from up to speed on the current tech for insulin dependence or the newer drugs for type 2s.
My area has lost the best endos in town during covid. One became medical director of an online clinic/platform. One moved to pharma. My long term endo became ‘out-of-network’ when insurance changed the boundaries of where we are allowed to seek care. We lacked an endo (within a 45 min drive) for a long time, but there were these issues of ‘no consistency’ of care under any one provider. As soon as you find a provider, they leave. I’ve just given up and am going through a primary care physician. We will see how that plays out. I figure that I am knowledgeable enough for that and I had better just leave the endo for the nubes. She has a 3 month scheduling wait as it is.