Someone in the DOC (diabetes online community) recently said something to the effect of "The real 'diabetes experts' are the people who live with diabetes." (I paraphrased because I can't remember exactly what was said, or who said it - but that's neither here nor there). While I agree those who live with diabetes know more than the general public, I don't find people who live with diabetes to be experts in it (please don't lynch me). Let me tell you why...
Allow me to preface this post by telling you this: along my seven year journey to become a CDE, I found myself saying many, many times "Can't living with diabetes for ____ years count towards my contact hours?" I was frustrated with the fact that, despite living with diabetes for more than 2 decades, I still had to collect 1000 hours working with other people with diabetes.
Then I actually got into the field.
What I quickly realized was how extremely complex diabetes truly is. In all honesty, my knowledge of my own diabetes wasn't that much of a benefit to me. What helped me the most when it came to helping others manage D was my background in science and nutrition. In part, this is why I very truly, strongly feel your credentials are vastly important when it comes to being a CDE. This is also why I don't feel the CDE credential should be allowed to just "anybody" and especially not those who simply live with D (or care for others with D) but have no background in the scientific care and management of diabetes.
The phrase "your diabetes may vary" flits around the DOC quite often. This must be taken to heart when working with diabetes patients. In the beginning, I often tried to use my own experiences as a way to educate others. The problem is that my diabetes experiences aren't necessarily helpful to others, especially because my own experience lies solely in type 1 diabetes diagnosed as a child. As an educator wanting to help those better manage their diabetes, I have to take the time to learn, specifically, about their diabetes. Then I have to sift through the endless mounds information available to me to best choose which strategy may be most beneficial. These strategies are further complicated by other co-morbidities such as high blood pressure, elevated cholesterol, thyroid issues, and a myriad of other illnesses. Along with all those, one must then keep in mind the individual's level of activity, diabetes medication, as well as all other medications that may contribute to blood sugar discrepancies. And we can't forget age, level of education, mental health issues, socioeconomic status and so forth. Helping educate someone about diabetes very rarely includes a discussion of just diabetes. There is a lot of time I spend in preparation for each meeting with a person, so I can ascertain as much information as possible about his or her current situation.
...And then we all know diabetes doesn't necessarily play nice. You do everything "by the book" and throw your best laid tactics at it - and nothing works. While, if this was your own scenario, you may flip your hands up and say "I give up!", as a professional you don't have that option.
When I prepared for the CDE exam, I had to expand my knowledge to well past my own comfort zones of nutrition and a basic understanding of diabetes. I stretched my brain around all encompassing areas that can also directly or indirectly affect diabetes management. I studied medications - both generic and brand names - as well as their mechanism of action, dosages, side effects, common uses, and potential for combination therapy. Not only did I wrap my head around the pathophysiology of diabetes and its effects on all areas of the body, I had to learn about the development and care of other co-morbid conditions such as heart disease, obesity, renal disease, etc. Together, my depth of understanding of all these areas combined with my ability to practically and strategically apply these to real world situations, is what helped me pass the Certified Diabetes Educator exam.
It was not easy. Despite living with diabetes for nearly 24 years at the time I sat for the exam, as well as working as a dietitian and diabetes educator for three years, I still found myself wanting to answer some of the exam questions with "Well, if this was my diabetes, I would...." Unfortunately, that was never one of the A, B, C, or D options.
As I said earlier, diabetes is an incredibly complex disease. All of these complexities MUST be taken into account with each new patient I work with. Without an extensive scientific background, and continuously educating oneself on advances in the diabetes realm, I honestly don't see how anyone would be fit to properly help others in a medical standing.
So, in summary - No, I don't feel being a PWD (person with diabetes) or caring for a PWD makes you qualified to be a CDE. I think it takes a lot more education than that. While it's a gigantic pain in the ass, I agree with the current standards set forth by the NCBDE (National Certification Board for Diabetes Educators) to sit for the exam. It took me 7 years and most of my sanity, but I came through the other side with a greater appreciation of just what it means to be a CDE.
Not just anyone has my credentials. My credentials are important. They represent the years of hard work and effort I put forth to be able to stand proudly where I am and call myself an Expert in Diabetes Care and Management. I'm not half bad as a dietitian either. ;)
"Education is the most powerful weapon which you can use to change the world." ~Nelson Mandela