Benefits of a Certified Diabetes Care and Education Specialist

When Richard Smith was diagnosed with type 1 diabetes in 1985, he didn’t think he had much to learn. Diabetes ran in his family – his father and grandfather both had it. 

“I thought I knew everything,” he said with a chuckle. “Turns out, I didn’t know anything.” 

Now 65 and living in suburban Dallas, Smith has seen dozens of physicians over the years, but he says the turning point for his health only came when he began working with diabetes education specialists. After years of quick, 10-minute appointments where doctors adjusted insulin doses without much explanation, he finally found the deeper guidance he needed. 

“I’ve learned more from the diabetes educators than I have through any doctor,” he said. For the past decade, he has had regular visits with Dana Roseman, a CDCES at Integrated Diabetes Services. 

His appointments with Roseman, who also has type 1 diabetes, and another educator with the Department of Veterans Affairs (VA), typically last nearly an hour – long enough for him to fully understand the state of his health and be able to ask all the questions he has. 

“It's a different ballgame,” he said. “There’s no telling where I’d be now if I didn’t see her.”

When he first met Roseman, Smith’s A1C hovered in the 8-9% range. Today, it’s close to 6%. “I’ve literally been blessed by Dana and my diabetes educator in the VA system,” he said. 

Smith lost his eyesight to diabetes 20 years ago, forcing him to retire early from a career he loved with the U.S. Postal Service, but he’s convinced that his relationship with his diabetes educators has kept him alive: “It’s because of them, and my kidney doctor and my wife, that I'm still sitting here.”

What is a certified diabetes care and education specialist?

CDCES are medical specialists from a diverse array of backgrounds – dietitians, nurses, pharmacists, physicians, or exercise specialists – who have completed specialized diabetes education courses with the mission of empowering people with diabetes through education and support. 

“The important thing is it’s multidisciplinary,” Roseman explained. “There can be different backgrounds and different tracks they bring to the role. It doesn't have to be one thing.”

Both Roseman and her colleague Jennifer Smith, also a diabetes educator at Integrated Diabetes Services, said their own diagnosis with type 1 diabetes and early experiences with good diabetes educators convinced them to pursue a CDCES certification.

Smith, who was diagnosed as a teenager, originally planned to work in animal medicine. But that path gradually shifted. “As I learned more about my own navigation and management of type 1, I really enjoyed the nutrition part,” she said. 

With her sights on helping others manage their nutrition, medications, tools, and the mental load of diabetes (as she had learned herself), Smith went to work first in hospital care, then endocrine clinics, and eventually the private practice where she now works.

Roseman said her personal experience with a diabetes educator also became an unexpected turning point when she was diagnosed in her 20s. 

“My educator was my lifeline,” she said. “When you're diagnosed a little bit later in life, you don't have your parents doing all the work, and so your healthcare team is really your access point.” 

At the time, Roseman was focused on public health policy, but her experience with diabetes education shifted her focus. “I really saw becoming an educator myself as kind of the silver lining of my own diagnosis,” she said. 

Addressing the endocrinologist shortage 

Educators can fill in gaps left by the shortage of endocrinologists in the U.S., especially in rural areas. Even when people have access, many, as Richard Smith explained, often find the visits rushed and focused primarily on prescriptions and lab results. Education specialists don’t just extend the network of care, they enhance the kind of care that’s available. 

“The majority of endocrinologists are not educators,” Jennifer Smith said. “We do different things.”

Roseman added that the best scenario is to have both an endocrinologist and an education specialist on your care team to provide education, support, real-time data interpretation, and holistic lifestyle management. 

“It would be a big mistake to assume that if you're seeing an endocrinologist, then you're good and you don't need an education specialist,” she said.

Benefits of working with a CDCES

For many people with diabetes, working with a CDCES can be transformative. Here are a few reasons why.

More time, more depth

Jennifer Smith described the contrast. “Most education visits are about 30-60 minutes…whereas endocrine visits, I'm lucky to get 15-20 minutes, and then the doctor is like, ‘Great, I'll see you in six months.’”

That extra time allows for deeper exploration into lifestyle, food, stress, sleep, goals, and technology. 

“The food part takes time,” Roseman added. “And navigating through the lifestyle changes, ‘This versus that,’ or ‘Let's try this little goal,’ and then we meet again in two weeks, or whatever it is.”

Technology expertise

The world of diabetes tech continues to expand with the use of continuous glucose monitoring (CGM), automated insulin delivery (AID) systems, smart pens, apps, and algorithms. A CDCES can help people understand that data, optimize settings, and decide when new tools are worth trying.

“With all the data that we now have coming in from these devices, we can glean a lot of information,” Roseman said.

Structured support over time

This isn’t a one-off interaction – it’s a trusted relationship. Smith shared how one of her earliest clients transitioned from once-a-month visits to one-off check-ins as his life and goals evolved.

“Educators who are really good educators, you build a relationship that’s like a friendship,” she said. “And that friendship, it kind of unlocks doors to that person opening up about things that can help us see more in the data than their doctors.”

Notably, both Smith and Roseman acknowledged the deep psychological component of diabetes. 

“I always feel like I should have gone back to school and gotten a secondary degree in psychology because it’s so much a part of care with diabetes. You kind of follow people through their lives,” Smith said.

How much does it cost to see a CDCES?

Diabetes education is often covered by most U.S. health insurance – including Medicare and Medicaid – for people with type 1 or type 2 diabetes. 

“Some have a max time allotment, but it is always a covered visit,” Roseman said. “And then, we can bill insurance for something called medical nutrition therapy, and that's additional hours.”

Even services like CGM data interpretation are increasingly billable under insurance, she said. 

The primary barrier to seeing an education specialist isn’t the cost, Roseman said. “I see the barrier as getting the recommendation. It’s getting a doctor to say, ‘I am not an educator. Here is your referral to an educator to help,’” she explained.

In many cases, she said, the person with diabetes needs to know to ask their doctor for a referral. 

Where to find a CDCES

For people in the U.S., the Association of Diabetes Care & Education Specialists and the American Diabetes Association both have searchable directories of diabetes education programs and specialists. 

Increasingly, many CDCES also offer virtual visits. Smith said that more of her clients are now online, and because so much of the data can be reviewed remotely, education lends itself well to being remote.

The bottom line

Whether you’re newly diagnosed or decades in, a CDCES can offer the kind of personalized, long-term support that makes diabetes management feel less overwhelming and more doable.

In a healthcare environment where time is scarce, CDCES can be the missing link between medical care and improving daily life for those with diabetes by making sure they not only have the information they need but also know how to use it. As Roseman put it: “Part of being a good educator is spending the time.”

Richard Smith's advice to anyone living with diabetes is simple: “Find one as soon as you can.” 

Learn more about diabetes education here:

• How To Find Good Diabetes Care
• 5 Minutes With Dietitian and Diabetes Educator Bridget Wood
• Diabetes and Teens: How To Get the Best Out of Healthcare Visits