And Well Over 2,000 Hours Since

Caleb Frazier, a Registered Dietitian Nutritionist and Certified Diabetes Care and Education Specialist, spoke with us about his CDCES certification, which he obtained in 2014. (The CDCES credential is formerly known as Certified Diabetes Educator, or CDE) 

Why did you choose to get the certification?

“I became a CDE because I saw firsthand during my first few years working as a Registered Dietitian the tremendous impact that diet and lifestyle have on a person with diabetes. When a person with diabetes improves their diet, there is almost an immediate effect on the person’s disease state and often how they feel. Diabetes can be a very difficult disease to manage without help. Basically, I saw the CDE credential as an opportunity for me to be an expert provider for a large part of our population. If you’re interested in the statistics, currently more than 88 million Americans, or more than 1 in 3 adults, have prediabetes, and most of those don’t know it. Over 10% of adults in the US have a diagnosis of diabetes. I believe all people with prediabetes and diabetes deserve to have access to people like myself who can help them manage their condition to prevent further health complications.”


What was the certification process like?

“Luckily, I already had the first requirement of having the Registered Dietitian credential. To get the practice requirement, I worked as a dietitian in an outpatient medical clinic, working with endocrinologists and PCPs with a diabetic population to gain the experience and knowledge required to take the exam. I had to record how many hours of the day I spent specifically with the diabetic population. I looked it up, the other current requirements for the certification are:

  • A minimum of 1,000 hours providing diabetes care and education
  • Pass the exam
  • Maintain a minimum of 15 continuing education hours in diabetes each year
  • Renewal of certification every 5 years”


Was the exam challenging?

“It’s one of the hardest tests I’ve ever taken! You really have to know your stuff.” 


Is there a lot of new research evolving in diabetes management?

“The guidelines for diabetic care are updated yearly, and frankly, the basic standards haven’t changed all that much, though they do tweak them slightly year to year. 

What is changing rapidly is technology. The availability of blood glucose meters, continuous glucose monitoring (CGM) and insulin pumps is rising, as well as the technological integration available with them. The most important things to pay attention to are the best practices for each new piece of technology. I do see these new advancements working well, especially the blood glucose monitors, it’s really exciting.”


What’s the benefit of Medical Nutrition Therapy (MNT) for those diagnosed with diabetes?

“Oh, there are many benefits, and it differs per patient and what they need. Here are the four most common benefits: 

  1. MNT can help you get better control of your blood sugars
  2. Finding meal options and snacks that you enjoy, and can afford that lead to better blood sugar control
  3. Reducing your A1c (obtain and maintain an A1C in the optimal range for that patient)
  4. cost-effective way to help you manage your diabetes (insurance often covers MNT)

Other benefits include education of their condition, lab test results, how food affects their condition, and guidance for personalized changes to improve their condition. The accountability between patient and dietitian in their follow-up appointments has been long-demonstrated to be one of the most effective forms of habit change. Over time, patients also develop the ability to self-evaluate their progress towards their goals and reassess the changes that they’ve made.”


Why may someone want to see a Certified Diabetes Care and Education Specialist (CDCES)

“Your Hemoglobin A1c level is basically a snapshot of what your glucose levels have been, on average, over the past 3 months. I always recommend people get their A1c tested to make sure they’re managing their blood sugar levels appropriately. If you’ve received test results with the following levels, or a diagnosis of pre-diabetes or diabetes, let’s talk!

  • Pre-diabetes is having an A1c between 5.7 – 6.4%
    • I can work with patients with pre-diabetes and motivate them to reverse their rise in A1c levels, not just manage or maintain it.
  • Diabetes (A1c of 6.5 and greater)
    • I can work with those who have a diagnosis of diabetes to manage their A1c and prevent it from rising further, which can lead to more health complications. “


Is there anything else you want people to know?

“I do my best to meet people where they’re at in life. I won’t force a diet plan that’s unobtainable or unsustainable. Simple changes make a big impact.”