Updated April 02, 2007

Teaming Up for Better Diabetes Control

by Laura Hieronymus, M.S.Ed., A.P.R.N., B.C.-A.D.M., C.D.E., and Kristina Humphries, M.D.

Pinch hitters
A primary-care provider is not always a physician. Some people see a nurse practitioner or a physician assistant for their routine diabetes care.

Advanced Registered Nurse Practitioner. Nurse practitioners provide nursing and medical services to individuals, families, and groups. They may practice independently and/or in collaboration with other health-care professionals. They manage acute and chronic illnesses, as well as emphasize health promotion and disease prevention. Their services may include ordering, conducting, interpreting, and supervising diagnostic laboratory tests and prescribing nonpharmacologic and pharmacologic therapies. They can serve as counselors, educators, researchers, consultants, and patient advocates. Nurse practitioners are different from registered nurses in that they diagnose, treat, and manage health problems.

Physician assistant. Physician assistants are health-care professionals licensed to practice medicine with physician supervision. As part of their comprehensive responsibilities, physician assistants conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventive health care, and assist in surgery. In most states they can write prescriptions. Although they are supervised by physicians, physician assistants exercise autonomy in medical decision making and provide a broad range of diagnostic and therapeutic services.

Credentials
Health-care providers should have a basic knowledge base relative to their profession. Some important considerations in evaluating and choosing your diabetes team members include the following:

Degree from an accredited college or university. All of your health-care providers should hold a degree in their field of practice.

Registration or license. A health-care provider who is registered or licensed has successfully passed a national or state licensing examination for his professional discipline.

Board certification. Board certification assures the public that a health-care professional has completed an approved educational training program and an evaluation process that includes an examination designed to assess his knowledge, experience, and skills within his professional discipline.

Specialty certification. Health-care professionals can become certified in specific areas of expertise such as diabetes education and management. Currently, more than 10,000 health-care providers in the United States are Certified Diabetes Educators (CDEs). The CDE credential demonstrates that the health-care professional possesses distinct and specialized knowledge about diabetes and its treatment.

Some providers also have the Board Certified–Advanced Diabetes Management (BC-ADM) certification. This certification is available only for registered nurses, dietitians, and pharmacists who also have a master’s degree. Health-care providers with this certification have demonstrated that they meet nationally recognized standards in the specialty area of diabetes.

Some diabetes educators are also certified pump trainers (CPTs). This means they have completed a program designed by an insulin pump company to enhance their knowledge and expertise in the operation and training process for a specific brand of insulin pump.

A health-care provider may have more than one specialty certification that is diabetes-focused, as well as other certifications that are not specific to diabetes. In some places of employment, certifications are required; in others, they are voluntary.

Working as a team
Any working team needs a manager, or someone to coordinate it, and in a diabetes team, that job often falls to you, the person with diabetes. Although your team members should be willing to communicate among themselves, it will often be up to you to inform each member of any treatments prescribed by the others. You will also have to provide your medical history to each team member and keep them up to date. (For more about communicating with your team members, see "Maximize Your Team Meetings.")

Also in this article:
Maximize Your Team Meetings
Rounding Up Your Team

Laura Hieronymus is the program coordinator for an American Diabetes Association–recognized education service, and Kristina Humphries is a practicing endocrinologist. They are diabetes care and education providers at Drs. Borders & Associates, PSC, in Lexington, Kentucky.

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