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The Cost of Diabetes Self-Management Education? Priceless.
December 29, 2009
“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?
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