Association of Diabetes Care & Education Specialists

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A Response to the Article: Hospitals Lure Diabetes Patients With Self-Care Courses, But Costs Can Weigh Heavily

May 03, 2018
By: Donna Ryan, MPH, RN, RD, CDE, FAADE
Regional Director, Community Health and Outreach
Sacred Heart Hospital, Pensacola, FL

AADE President Donna RyanThe article Hospitals Lure Diabetes Patients With Self-Care Courses, But Costs Can Weigh Heavily illustrates the fundamental broken system of healthcare financing in the United States. Unfortunately, it did so at the expense of a proven diabetes intervention tool. AADE takes this very seriously and we have since submitted a Letter to the Editor after it appeared in the New York Times.

As AADE members, healthcare professionals, and those living with diabetes, we know it is a complex medical condition that if left unmanaged can lead to devastating complications and comorbidities. Through behavior change, Mr. Philips was able to lose weight and lower his blood sugar to within the recommended range, saving him from a lifetime of prescription medications and possible complications including heart disease and stroke, blindness and other eye problems, nerve damage, kidney disease, and amputations. Studies show that a reduction in A1C of just 1 percent can vastly reduce the risk of these complications.

Understanding the disease and gaining the knowledge to take self-management actions puts the person in a proactive position to manage healthy eating, being active, monitoring, taking medication, problem solving, reducing risks, and healthy coping... what AADE calls the AADE7 Self-Care Behaviors™.

Unfortunately, diabetes is often downplayed by our healthcare system and our culture due to stigma associated with the disease, misconceptions about the seriousness of the diagnosis of a lifelong chronic disease, and the challenges of daily self-management.

It is problematic that this article blames the issues with our healthcare system on a program such as the one attended by Mr. Phillips. The knowledge he gained allowed him to make changes that will significantly reduce his risk for developing the many commodities that are often seen with diabetes.


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  1. May 06, 2018

    Thanks for the strong response. Some providers are  grateful for the help in providing optimal care to their patient’s. Besides the Endocrinologist, Some providers have general diabetes knowledge and DSME is the compliment to care. DSME courses are priceless while offsetting future complications. DSME are sometimes give for free.  Some may find it fancy to write about the endless complications of Diabetes rather that the patient’s achievements in delaying debilitating complications. There should be no patient left behind without specialty access to evidenced based Diabetes Education. 

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