My Goal to become a Certified Diabetes Care and Education Specialist (CDCES)

Written by: Kai Wan, SLU Dietetic Intern

The story of my diabetes education

I was matched to the Dietetic Internship program at Saint Louis University in 2021; I will be finishing my internship this August. My short-term goal is to become a registered dietitian and a CDCES.

My first clinical rotation was about Diabetes back in August of last year. This rotation only lasted two weeks and I thought that would be all the time that I was going to spend on studying about diabetes. However, I was totally wrong. Soon after I went into my gastrointestinal rotation, I saw patients with GI issues and diabetes. In the renal rotation, I spend a lot of time educating my patients about how to manage their diabetes to decrease the risks of further kidney damage. I have also seen diabetes patients in the geriatric, pediatric, and almost every other rotation. What’s more, I was assigned the topic of “self-management on diabetes and hearing loss program” as my capstone project at the beginning of my internship, which was actually my second choice. It feels like it was fated when I’m looking back now.

What is CDCES and how do you become one?

Certified Diabetes Care and Education Specialists are a group of healthcare professionals who provide collaborative, integrated, and individualized care and education to people with diabetes and diabetes related conditions. They are the healthcare providers who have achieved a high level of knowledge and skills in the biological and social sciences, communication, counseling, and education and who have experience in the care of individuals with diabetes (ADCES, 2022).

Briefly, healthcare providers like nurses, dietitians, pharmacists, physicians, mental health professionals and others who choose to specialize in diabetes education are able to become a CDCES. Individuals who pursue the CDCES credential will need at least 2 years of professional experience, plus 1,000 hours of diabetes education over the previous four years, complete at least 15 hours of continuing education from a provider recognized by the Certification Board for Diabetes Care and Education (CBDCE) within two years of applying for the exam, and pass the CDCES examination.

What made me want to become a CDCES?

There were so many reasons that contributed to my decision to pursue becoming a CDCES.

Just as I mentioned before, I have interacted with a lot of diabetes patients in almost all of my rotations. Not only Have I learned a lot of new information about diabetes while I was preparing the interactions and educations, but also I have realized that there is a unique story behind every single patient with diabetes which has always triggered my curiosity to learn more about the relationship between lifestyle and diabetes.

I was so lucky to have more than one CDCES’s as my preceptors and mentors during my internship and graduate school. What inspired me the most is all of them are extremely passionate on diabetes educations. I could feel their passion from each patient interaction that I observed. I could feel their excitement when they see patients improved lab values. I could feel their happiness when a patient makes positive comments on the education they were given.

The prevalence of diabetes in the US has been increasing dramatically in the past decades, which means that there are more and more people that would benefit from receiving diabetes education. According to data from CDC, as of 2022 there are 37.3 million people that have diabetes in the U.S., which is 11.3% of the entire U.S. population (CDC, 2022). My grandmother passed away due to the complications of diabetes. I wish I knew more back then so I would be helpful to teach her on how to follow a consistent carbohydrate diet and switch lifestyle choices to improve her diabetes management. I believe that she would love to see that I am pursuing to become a CDCES and help more people with diabetes.

Sources:

https://www.diabeteseducator.org/practice/becoming-a-diabetes-care-and-education-specialist https://online.adelphi.edu/articles/certified-diabetes-educator/#:~:text=The%20professional%20practice%20experience%20requirement,of%20applying%20for%20the%20exam CDC, https://www.cdc.gov/diabetes/data/statistics-report/index.html

RDs as Lactation Consultants

Written by: Haley Pucel, SLU dietetic Intern

One of the many roles a Registered Dietitian (RD) can take on is a lactation consultant. Lactation consultants are a vital tool for new mothers to successfully initiate and maintain breastfeeding as a means to nourish their child. While a majority of lactation consultants are nurses, Registered Dietitians are eligible to follow this career path as well.

Breastfeeding is important because it provides milk specialized to the infants needs as they develop. Breastfeeding provides numerous benefits to both babies and mothers. Some of these benefits for breastfed babies include having stronger immune systems, fewer cases of necrotizing enterocolitis (NEC), fewer colds and respiratory illnesses, fewer ear infections, lower rates of infant mortality, and lower rates of sudden infant death syndrome (SIDS). These babies are also less likely to develop allergies, asthma, and eczema, and have a lower risk of type 1 and type 2 diabetes. Breastfeeding is beneficial for mom by stimulating the uterus to contract and return to normal size, less postpartum bleeding, fewer urinary tract infections, and less risk of postpartum depression. Breastfeeding can also assist mom with bonding with the baby and feeling confident learning her baby’s cues.

During my most recent rotation at Cardinal Glennon Children’s Hospital, I had the opportunity to shadow a lactation consultant. The lactation consultant was a gold mine of information. During my time shadowing, I was able to see lactation issues addressed including overproduction of milk, worries over making enough milk, and latching. One component of the lactation consultant job that I was unaware of before shadowing was how much of the role was empathizing and counseling mothers in their ability to provide breastmilk for their child. The lactation consultant emphasized that her role really is to build relationships with the mothers so that they feel comfortable discussing their barriers to breastfeeding. Breastfeeding is both a physical act but also an emotional one as mothers learn to bond with their baby. I also was able to see where the hospital stores mothers’ breast milk and even was able to assist with putting away donor breast milk from The Milk Bank. This experience validated my interest in lactation, and the lactation consultant encouraged me to pursue this career path.

Why do Registered Dietitians make valuable lactation consultants?

Registered Dietitians possess the knowledge of the nutritional benefits of breastmilk, and thus promote sustained breastfeeding for at least the first 6 months of an infant’s life. RDs know the nutrients and amount of breast milk an infant needs for proper growth and development and can work with mothers to make sure the infant is intaking all the nutrients needed to be healthy. RDs can address both the nutrition intake of the mother and infant to problem solve issues relating to milk adequacy. RDs can counsel the mother on barriers to breastfeeding to ensure its continuation.

Where can a Registered Dietitian work as a lactation consultant?

Lactation consultants work in a variety of settings. Many work in hospitals and others work in private practice or clinics. Pediatric dietitians are an essential tool for troubleshooting breastfeeding in the neonatal or pediatric intensive unit because these children might need modified feedings to meet their needs and mothers may need assistance with expressing breast milk and establishing a breastfeeding relationship with their child.  Another place lactation consultants work is at the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) because WIC is known for their strong promotion of breastfeeding.

How do I become credentialed as a lactation consultant?

Despite lactation consultant credentials not being required by federal or state law, credentialing shows expertise and may provide career opportunities. Certification can be provided through the International Board of Lactation Consultant Examiners (IBLCE), which is the only lactation consultant certification program fully accredited by the National Commission for Certifying Agencies. There are multiple pathways to meet eligibility to sit for the exam but it is designed for the lactation consultants to have a health sciences background, minimum of 95 hours lactation specific education, and relevant clinical experience. For more information, visit the IBLCE website (https://iblce.org).

Breastfeeding is a proven health benefit to both infants and mothers. Registered Dietitians can be breastfeeding advocates by educating on the immense benefits of breastmilk and assist mothers with lactation. For those who are passionate about breastfeeding, consider becoming a lactation consultant because it will assure sustained breastfeeding which is vital for the health and future of infants and mothers.

 

References:

https://my.clevelandclinic.org/health/articles/15274-the-benefits-of-breastfeeding-for-baby--for-mom

https://iblce.org/

https://www.themilkbank.org/

Diamond, Lynnell. Lactation Consulting. Is it for you? American Dietetic Association. https://doi.org/10.1016/S0002-8223(97)00152-1