Diabetes Self-Management Blog

“Would you pay fifty-four dollars to see me?” Sandy asked.

It was a couple of weeks ago, and I was driving her back to her car after spending an afternoon over a leisurely lunch followed by meandering through stores while she finished up her shopping list.

My first thought? Why would my friend want me to pay to see her? I paid for the shared appetizer and even bought a cup of chai latte and a pastry for her, and this is how she wants to repa…Oh. She’s trying to figure out what to charge for diabetes education. I think.

“Yes, because I recognize the value of diabetes self-management education,” I said. Then, because I was curious, added: “How did you come up with fifty-four dollars?”

Turns out that’s the amount the place where she teaches a class charges for one-on-one with the registered dietitian. “The only reason I can figure,” Sandy said, “is that’s about the amount necessary to cover creating a record for that person in the accounting department.”

Back in the day — which would be 1995 — I paid $100 an hour for diabetes education. No, I don’t know what that is in today’s dollars. What I do know is that the place I go to now doesn’t charge anything. Maybe they can’t get anybody to pay for diabetes self-management education.

The $100 an hour was out-of-pocket, too, because my insurance coverage is through a university and it doesn’t cover diabetes education. (I know: It doesn’t make sense that a place that specializes in education doesn’t cover the product it sells, but that’s the way it is.)

It seemed to me to be a bit expensive, but I quickly put that notion out of my head. Why? I learned more in my first two hours than I’d learned in the nine years since I’d been diagnosed with Type 2 diabetes. As an aside, it was also the day I discovered there were magazines focusing on diabetes. And it was the day I decided I wanted to learn enough about diabetes to be able to write about it. So I not only began learning about how to manage my diabetes, I also began my path to making a bit of a career change.

It’s the bit about learning to manage diabetes that’s the more important of the two, however. I was lucky in that I had excellent teachers; Sonja as my nurse educator and Amy, then Sheila, as my registered dietitians — and CDEs all.

Nobody lectured me. Nobody tried to stuff me into a box marked “diabetes” that I didn’t fit into. Rather, they asked me what my lifestyle was like and began teaching me how to fit diabetes into that lifestyle. I began to learn cause and effect, such as how exercise and food affects blood glucose control. It’s amazing how much easier (that’s easier — not easy) it is to manage blood glucose levels when you have a clue about how things work.

Of course, it’s not as simple as balancing food, physical activity, and medicine. I also learned that stress, hormones and, perhaps, the alignment of the planets also can affect glucose levels.

If you’ve never seen a CDE, or haven’t seen one for a while, I urge you to start the new year off right by making an appointment with at least an educator and a dietitian. If you’ve never been to a CDE, it’s about time you started. If you haven’t been for a while, you might be amazed at the changes that have occurred in the past few years.

Don’t settle for just anyone: Make sure it’s somebody you can work with and somebody who will work with you rather than merely offering lectures. We have to learn to live with a lifelong condition. We deserve personal attention.

I’ve fired a few educators and dietitians (have I told you about the one who had me in tears?) over the years: You can, too. After all, why should doctors have all the fun of getting fired?


  1. I heartily agree with Jan. My first session with the CDE was really informative! My insurance paid for my first one, but I try to catch a class at least every 5 years. I paid about $50 for my last one a few years ago. I do that because even though I had pages of notes and handouts, things slip through the cracks in those years. That way, too, I catch up on the newer advances and procedures. My first class was also the place I saw my first “Diabetes Self Management” magazine and I have been hooked ever since. I much prefer the online version now because I love the blogs and interaction. I would recommend to every diabetic to stay on top of the educational opportunities out there no matter what their ages are. My aunt was recently diagnosed with diabetes at 80 and her doctor, who is almost as old as she is, told her nothing except to watch what she ate and drank and handed her a diabetic meal plan from the 1980s. Thankfully she loves the computer so I helped her find your website and a few more and from there she was off and running. Needless to say, she and her doctor had a really long discussion on her next visit! I have to say that my education is much better and it is due in part to the internet, my classes, and my endo and other people on my health team. I still struggle with the numbers but at least I understand some of what drives them in the first place. I agree with Jan also that some of it does seem to be dependent on how the planets are aligned.

    Posted by Cathy |
  2. I read your article on you firing your Drs. and enjoyed it very much.I subscribed to Diabetes Selfmanagement several years ago and have enjoyed it very much.I recommend it to just about everyone that I talk to that haqs diabetes I find it very informative. I also keep a close check om my glucose numbers. My last A1c was 6.2 Keep up the good work.

    Posted by Tom Hargis |
  3. I agree with Jan also. Diabetes is a chronic disease that NEVER goes away. Consequently effective self management is essential to achieve proper health and the joy that goes with it.

    Did you know research shows that less than half of the 24 million diabetics in this country have had any education.

    I’ve had Type 2 for over 30 years and have learned that the more I know about the disease the better equipped I am to achieve self-care mastery.

    My business partner and I are in the early stages of offering diabetes education in a variety of venues. I call myself The Joyful Diabetic and my blog site provides information and suggestions about living wonderful, joy-filled lives with diabetes.

    Posted by Will Ryan |
  4. I’m reading this a year later, but wondering if anyone has ever paid $900.00 for Diabetes education? That is what the hospital is charging me (although they failed to mention how much it was or that my insurance would not be paying for it.) It was three 3 hr lessons in which I learned very few things that I didn’t already know from the classes I had (for free) when I was first diagnosed. I went because my doctor insisted as I was completely out of control.

    Don’t get me wrong, the ladies teaching the class did a fine job. But for $900 I want a bit more than some photo copied papers. (Might I also mention that I’d like my money back for the 40+ minutes that were wasted before class/after break/ and anywhere else with people just shooting the breeze?) For $900 I could have probably taken a course in nutrition. I find it appalling, especially when surrounding hospitals have free education. I know I should have been more assertive, but I was following Doctor’s orders.

    I was just wondering if this price sounded normal to any one?

    Posted by Johanna |
  5. I really enjoyed this article. We run a Diabetes Education and Management organization, doing classes and one on one consultations in the D.C Metropolitan area. We recently started offering services outside of the area and online as well, because we’ve found that hospitals seem to overcharge, and CDE costs may not be covered by insurance.

    Posted by Osei |

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