The Future of Diabetes Care with AADE President Karen Kemmis

Karen Kemmis, PT, DPT, RN, MS, GCS, CDE, FAADE, the president of American Association of Diabetes Educators (AADE), has worked in the diabetes space for over two decades.

Recently the AADE unveiled Project Vision, a “multi-year initiative to position diabetes educators for success within a dynamically changing environment.” As part of Project Vision, Kemmis revealed in the opening address at the AADE 2019 Annual Conference that diabetes educators would be getting a new title to better reflect the breadth of their roles—’diabetes care and education specialists’.

Kemmis recently spoke with Beyond Type 2 about the exciting changes happening at AADE and the future of diabetes care. 

BT2: Hi Karen and thanks for speaking with us today—to start can you give us your background in diabetes care?

KK: I have been a physical therapist for 35 years, and 24 years ago I was fortunate to get hired for a position at a diabetes center in Syracuse, New York. I got my CDE (Certified Diabetes Educator) credentials 20 years ago, I went to my first AADE meeting 19 years ago, and I got involved in the leadership level in 2005.

Can you tell us more about Project Vision?

A couple of years ago, the board, leadership and staff decided that we really needed to take a look at what would allow diabetes educators to be successful in the future, and we came up with Project Vision. There are six pillars or strategies that we focus on that will move us into the future.

1. Drive Integration
2. Include Related Conditions
3. Focus on Behavioral Health
4. Leverage Technology
5. Promote Person-Centered Care
6. Achieve Quadruple Aim

As we went through that process, one thing really came to light, and that is that the term “diabetes educators” does not at all describe or encompass what we really do. We know that we’re underutilized as a service. In spite of that, we know that when the person goes through diabetes education, they can have improved clinical and quality of life outcomes.

The first day when I talked about it in my address at the conference, I was surprised. I could just tell that hundreds of people in the audience who were clapping and cheering agreed that this was the right move—that people have worked for this change for a long time to really help them in their practice.

What was the thinking behind the name change from diabetes educator to diabetes care and education specialist?

Diabetes educator really musters up the image in a lot of people’s mind that, “I’m going to go see this person and they’re going to teach or tell me what to do.” There’s so much more than that. When a person goes to see a diabetes educator, that specialist takes their medical history and knows their socioeconomic status, really looks at what that individual’s goals are, evaluates those goals with that person and creates a plan with the individual and carries it out. I hope people will start to think, “When I go see a diabetes care and education specialist, I’m going to get holistic collaborative care from somebody with clinical expertise.”

The decision to change the name was made through a pretty extensive research process in coordination with a professional research and brand strategy firm. It included surveys of healthcare professionals who work in the field of diabetes, AADE members, non-members, people with diabetes and other key partners. A steering team of AADE board members and leadership directed the project and included engagement and input from the National Certification Board for Diabetes Educators (NCBDE), the accrediting body for the Certified Diabetes Educator credential.

The initial research determined that the term diabetes educator does not accurately describe all that we do for people with diabetes or those at risk for diabetes, the larger healthcare system, payers and providers. Several names were tested with AADE members, people with diabetes, professional organizations and others, and across the board, diabetes care and education specialist (DCES) was the preferred term. Among other benefits, the addition of the word “care” more fully defines the role we play in the larger diabetes care team, and the word “specialist” adds a level of expertise and professionalism to the title. We hope that this new name, in coordination with Project Vision, will help to position us as a pivotal component of diabetes care and a central point of care for people with diabetes.

One concern that has come up with many AADE members is the question of the CDE credential. There’s this fear of, “Oh my gosh, we’re going to have a name change. Does that mean I have to take my test again, or do I not have this credential anymore?” The answer to both of those questions is no. The CDE credential is managed by the National Certification Board for Diabetes Educators (NCBDE), not AADE, and will continue to function as it always has. We worked with NCBDE to answer some of the most common questions in an FAQ you can access here

One way to really demonstrate that you have competence as a diabetes care and education specialist (DCES) is to have your CDE credential, to be a certified diabetes educator who has put the clinical hours in and taken that exam. The CDE is still the credential, and it’s a great credential. I’m proud to have it. CDEs can now say, “I’m a certified diabetes educator, and I’m a diabetes care and education specialist.” It opens the door for other people who don’t have their CDE for one reason or another, because there are a lot of other avenues to demonstrate that one is a specialist in this area. 

How has diabetes care changed over the past couple decades?

One of the most important shifts I’ve seen in my career has been to person-centered care, which has always been the vision at AADE. There was a time when a person with diabetes went to a health care provider and was told what to do, not asked questions and certainly didn’t have treatment plans tailored to them.

Now, we really make a point to engage with the individual and see what’s going to be best. Guidelines are great, but they need to be adjusted for every individual no matter what the guideline or recommendation is. So, person-centered care, holistic care and really collaborative care are key. I’m not telling a person what to do—I’m working with that individual to help them do the best they can with their diabetes.

What are your thoughts on peer support communities?

Not all that long ago, I think a lot of healthcare professionals were skeptical about what someone would come into contact with if they engaged with people online via social media, and we’ve come a long way since then.

Over the last six to eight years, there’s been such a strong push for healthcare professionals to engage with peers and those they serve. Whether it’s the diabetes online communities where the focus originally went, or our in-person communities, it’s important to understand how much a person with diabetes can capture from those interactions with peers.

People with diabetes don’t have to go to a healthcare professional to know the best way to treat a low blood sugar, or for pump site suggestions if their current site isn’t sticking well. People who live with diabetes and support others with diabetes have so much valuable information. I think part of our job as healthcare professionals is to know where to guide people and to encourage them to access people out in the community, both online and in-person. 

What are you excited about in regards to the future of diabetes (other than a cure)?

It’s got to be the technological and medical advancements that are coming at a record speed. I was just talking to some of my physical therapist friends today, and I told them about the inhaled glucagon. One of them said, “It is so cool that we get to know what’s out there right away.”

As far as our end of things go, I’m excited that more people are going to say, “Hey, I want to go see a diabetes care and education specialist to learn what’s new and to learn what strategies we can work together on to help with my management.”

We’re really helpful people, and I hope people with diabetes cling onto the idea that we do both care and education—it is collaborative, it is holistic and we’re part of the care team. It’s going to make it more interesting, more rewarding and hopefully it will help a lot more people.