Report From the AADE: In the Convention Center with Diabetes Educators

Diabetes Health just returned from the annual meeting of the American Association of Diabetes Educators (AADE), in Washington, D.C., August 6 through 9, 2008. Journalist, Riva Greenberg joined 3,500 attendees in, as AADE President, Amparo Gonzalez, RN, BSN, CDE, said, “taking on the challenges of delivering diabetes education in today’s healthcare environment.”

Most of the educators I spoke with find changing patient behavior difficult and challenging, yet they derive enormous fulfillment when they can help a patient succeed.

| Aug 21, 2008

The members of the AADE are an impassioned group who genuinely want to make a difference in their patients' lives. It was an ideal place for me to be, especially because I had a concern of my own: Why am I getting red dots every time I inject? Every educator I asked went right to work examining the problem and investigating my behavior, truly wanting to help. Unfortunately, they are dwindling in number each year, while patients are increasing in number, making their work ever more demanding.

My husband and I descended upon Washington together, both eager to hear what educators are learning and teaching, what's new in the field, and how patients are being served. I also wanted to personally thank the many experts who were speaking there and are helping me with the book I'm currently writing, debunking diabetes myths.

When we arrived the night before the conference started, our first task was to find fruit for my husband's breakfast the next day. Would you believe that within a 20-block radius of downtown D.C., there is not a banana, orange, or apple to be had? Trust me, I know; I asked shopkeepers, restauranteurs, passers-by, and my hotel concierge. The closest we came was Tang, a powdered orange drink at a CVS drugstore. It is remarkable that only blocks away, 4,000 people had convened to learn how to help patients improve their diet and eating habits, and yet in our nation's capital, I could not find a piece of fruit.

The conference was opened by Amparo Gonzalez, current president of the AADE, in the convention center's great basement hall. I sat among a sea of predominantly Caucasian middle-aged women: there was perhaps one man to every 50 women. Elizabeth Edwards, the keynote speaker, gave an hour-long, impassioned address, sharing her own experience of living with cancer, and built a bridge between all of us who live with a chronic illness. She was real, warm, bright, funny, and engaging. She described her darker days with cancer and spent the last 15 minutes comparing the health plans of Senators McCain and Obama. Although she promised to be impartial, which I believe she was, she gave both plans low grades, letting us know that neither is as workable as their authors would have us believe. I left concerned that our already broken healthcare system will not be fixed anytime soon. Unfortunately, two days later, Ms. Edwards' marital problems were being reported on the convention center's TV monitors.

What Educators Are Learning:

New medicines that deal with type 2 diabetes, and more on the horizon, indicate that diabetes is not merely an insulin problem. Gastric hormones are getting more and more attention.

The artificial pancreas is inching ever forward in trials, largely due to the efforts of the Juvenile Diabetes Research Foundation.

Diabetes educators' biggest hurdle is getting patients to adopt healthier eating habits and exercise.

Their second biggest hurdle is getting patients to sustain healthier behaviors once they've adopted them.

Educators are being encouraged to move from being "teachers" who instruct patients to being "coaches" who partnera with patients.

Peers for Progress is a new AADE initiative getting underway to utilize patient mentors. We knew it was coming because there are too many patients for too few educators.

Personal note: My book, The ABCs Of Loving Yourself With Diabetes, which was initially declined by the AADE bookstore because it wasn't deemed something educators would find useful, sold out!

Most of the educators I spoke with find changing patient behavior difficult and challenging, yet they derive enormous fulfillment when they can help a patient succeed. In truth, I'm surprised that there isn't a higher burn-out rate among educators.

The Exhibition Hall

Let's be honest: the most fun at one of these events is looking at all the stuff in the exhibition hall and, of course, eating your way through it. I managed to lunch almost every day on low-fat blueberry yogurt, Activia, walnuts, cereal bars, Lean Cuisine, and soft serve ice cream. I also partook of lots of nibbles that resembled food, but I'm not really sure they were. Gadget-wise, I didn't find all that much that I hadn't seen in previous exhibition halls, but these things are worth mentioning:

Eat Smart. This is a small, great-looking scale that measures everything and tells you not only how much it weighs, but also its calories, carb content and seven or so vitamins and minerals. To be honest, my husband was immediately attracted to the gadgetry, while I thought, oh, another thing to be bothered by. But we have it in our kitchen now, and knowing that the plum I'm about to eat has 27.6 carbs is an incredibly useful addition to my management.

Meters, meters, meters everywhere. Glucose meters have become a ubiquitous product, but one by Intuity did catch my eye. When you put your finger over a hole at the bottom, it pricks it, and in seconds it gives you your blood sugar reading. Notice, no test strip. It's due out next January. Now let‘s just hope they make it a little less masculine looking.

On site A1c testing. I learned only recently that many doctors offer A1c testing right in their offices, while I'm always trekking off to the lab. Well, here at the show I could avail myself of five booths that would give me my A1c result within minutes, so of course I had to test it. I tried three different booths and came up with 5.0%, 5.4%, and 5.5%. Given that I'd had my A1c done at the lab just two weeks ago and it was 5.8%, I'm inclined to say that two of the three tests at the exhibition hall were in the ballpark. Reli-On also sells a kit that allows you to put a drop of blood on a sheet and mail it to them; within a week, they'll mail back your A1c result.

My lancing device ratings. Since we all know that lancing devices cause more pain than injections, I have a personal investment in keeping up with improvements in this area.

Pelikan Sun. This is my first place winner. It's battery operated and has a feather touch. Downside: It's expensive, about $200 for the instrument, which is a little larger than a pack of cards. Upside: I'm told that the lancets should be covered by insurance, and you won't mind testing 10 times a day.

Accu-Chek Multiclix. The best, least painful cheap lancing device. It runs on a track so that the lancet doesn't shred your skin when piercing. My favorite run-of-the-mill device.

Renew from Can-Am Care. Operates on the same track technology as Multiclix. Cool packaging, but feels not quite as sturdy as the Multiclix, although that could merely be my perception.

Pumps are getting smaller and more are getting tubeless. Omnipod, the only tubeless pump right now, promises a pump half its current size within two to three years. Medtronics is working toward the same. I'm staying tuned: I've always said that when a pump is the size of a credit card, count me in.

Omron, a company that makes blood pressure machines and pedometers, is coming out with a slim new pedometer next year that will work at any angle, so you can slip it in your pocket rather than clip it on your belt. I like the ease of putting it in a pocket, and my husband loves the techie gadgetry.

Glucose Rapid Spray. Five to 10 shots of this tiny atomizer mist spray onto your inner cheek will bring your blood sugar up when low. It's handy to carry when away from home or exercising. I'm waiting for my next low blood sugar to give it a try.

Dreamfields. A dream of a pasta. I gave up pasta for a dozen years due to how high and how quickly it raised my blood sugar. Now Dreamfields has created a pasta that nets only 5 grams of carbs per serving, and I know it works. They've reconfigured the pasta's molecular structure, and much of it is highly non-digestible when traveling through your stomach. It still tastes delicious, but it doesn't break down into carb. I swear, give it a shot. I find it at my local supermarket chain, Key Food, but they're distributing many places.

Helping Third World Children with Diabetes

The conference was closed by Dr. Francine Kaufman, pediatric endocrinologist at the Center for Diabetes, Endocrinology and Metabolism at Children's Hospital in Los Angeles. Dr. Kaufman is a tireless advocate against childhood diabetes. She shared clips from a documentary she made for the Discovery Health Channel, "Diabetes: A Global Epidemic," in which she traveled through Africa and India bringing medicine, training, and treatment to poor children, families, and caretakers. Countless children are dying of diabetes because they have no medicine, no meters, no test strips, and no doctors. In places where insulin can be obtained only on an irregular basis, the children are given whatever is available. Can you imagine using only Humalog one month, then only Lantus another, then NPH yet another? How would you ever figure out your protocol? I get chills just thinking about it.

If you would like to donate unused, unexpired medical supplies to this cause, they are taking them at You can also contribute money: for one dollar a day, a child will receive medicine and testing supplies.

As I leave the convention center and end my report, I would like to leave you with my own closing remark. I find it profound that here in America we are literally dying of abundance, too much food, and too many luxuries that make us lazy, while elsewhere people are dying of scarcity, too little food, too little medicine, and too few healthcare professionals.

It's something to ponder.


Riva Greenberg is a patient-expert and A1c Champion. To read Riva’s blog and learn more about her work, please visit her website,

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Categories: A1c Test, Blood Sugar, Diabetes, Diabetes, Events, Food, Glycemic Index & Carb Counting, Insulin, Insulin Pumps, International, Lancing Devices, Lantus, Losing weight, Low Calorie & Low Fat, Low Carb, Meters, Professional Issues, Type 2 Issues

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Posted by Barbara Bradley on 22 August 2008

"Educators are being encouraged to move from being "teachers" who instruct patients to being "coaches" who partnera with patients."

Pardon me, but this is not a new concept. I am well aware of many CDE colleagues who "coach" their patients. For the past 18 years, I have introduced myself as a guide, cheeleader and coach for the people with diabetes that I work with. I don't see this as a new concept, but a reminder to new educators and for a few who have a "teacher" complex.
Bab (MS, RN, CDE)

Posted by Anonymous on 22 August 2008

perhaps he doesn't select where to inject the needle; I inject my insulin on my upper arm or side of my stomach or my tigh.

Posted by seashore on 29 August 2008

The report says, "Diabetes educators' biggest hurdle is getting patients to adopt healthier eating habits and exercise". What do they mean by "healthier eating habits"? The AADE probably follows the advice of the American Diabetes Association (ADA), which insists that diabetics should eat a high-carb diet. Nevertheless, there is overwhelming evidence that a high-carb diet makes diabetes wowrse; a healthy diabetic diet must be low in carbs.

Posted by danbrown on 9 October 2008

The author laments the fact that within a large radius of the AADE convention there was no place to buy fresh fruit! -- a food that is all sugar and a little fiber. And then she laments, if I understand her, the the number of diabetes educators is declining while the number of T2 diabetics is skyrocketing. She and the ADA clearly do not see the anacrinism or the irony of this. The previous poster is absolutely correct. Blood sugar control is achieved by strictly, even sevevely limiting carbohydrate intake, and unfortunately that includes fruit. When will "the professionals" get it? Eat to the meter!

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