The Cost of Diabetes Self-Management Education? Priceless.

“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[1]. 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 CDE[2]s 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[3] 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. Type 2 diabetes:
  2. CDE:
  3. exercise:

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Jan Chait: Jan Chait was diagnosed with Type 2 diabetes in January 1986. Since then, she has run the gamut of treatments, beginning with diet and exercise. She now uses an insulin pump to help treat her diabetes. (Jan Chait is not a medical professional.)

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